NACCHO Aboriginal Health and #COAG Health Ministers Council Communique : Peak bodies welcome Roadmaps to address high priority health issues #RenalHealth  #EyeHealth #RHD #RheumaticHeartDisease #Hearing Health and #Housing

We welcome the COAG Health Council’s commitment to the RHD Roadmap today.

The RHD Roadmap was developed by the National Aboriginal Community Controlled Health Organisation (NACCHO) on behalf of END RHD.

We look forward to supporting the AHMAC review of the RHD Roadmap, and ask that the National RHD Steering Committee – which underpins governance of the RHD Roadmap – be convened as a matter of priority to oversee development of the implementation plan. ” 

END RHD Press Release see 2.30 below for full release 

“ The need to close the gap for vision and achieve a world class system of eye health and vision care for Aboriginal and Torres Strait Islander people is a critically important objective and rightly belongs on the national agenda.”

The fact Aboriginal and Torres Strait Islander people are still three times more likely to experience blindness than non-Indigenous Australians illustrates the need for action.

We welcome the leadership shown by Minister Wyatt in bringing this issue to the COAG Health Council, and strongly encourage all governments and all sides of politics to join together with Aboriginal and Torres Strait Islander communities, their organisations and Vision 2020 Australia members to close the gap for vision.”

Vision 2020 Australia CEO Judith Abbott:

The Federal, state and territory Health Ministers met in Adelaide last Friday at the COAG Health Council to discuss a range of national health issues.

The meeting was chaired by the Hon Roger Cook MLA, Western Australian Minister for Health and Mental Health.

Major items discussed by Health Ministers today included:

1.National Aboriginal and Torres Strait Islander Health and Medical Workforce Plan

2. Roadmaps to address high priority health issues for Aboriginal and Torres Strait Islander People

2.1 Renal Health 

2.2 Eye Health 

2.3 Rheumatic Heart Disease 

2.4 Hearing Health

3.Diseases of housing overcrowding and poverty in remote Aboriginal and Torres Strait Islander communities

1.National Aboriginal and Torres Strait Islander Health and Medical Workforce Plan 

At the August 2018 Indigenous Roundtable Health Ministers agreed to develop a National Aboriginal and Torres Strait Health and Medical Workforce Plan that provides a career path, national scope of practice and attracts more Indigenous people into health professions.

Ministers discussed the approach to develop the Plan noting that the Commonwealth will provide resources to lead its drafting, in full consultation with states and territories and other key stakeholders.

Ministers noted that in the course of developing the Plan, there may be value in engaging with other relevant COAG councils with workforce and skills responsibilities to realise meaningful, sustainable outcomes.

A draft Plan will be submitted to the next CHC Indigenous Roundtable in July 2019.

Roadmaps to address high priority health issues for Aboriginal and Torres Strait Islander People

At the July 2018 COAG Health Council meeting, Health Ministers discussed the potentially preventable burden of disease in Aboriginal and Torres Strait Islander communities caused by a number of health conditions. They discussed work to date to address these health conditions and opportunities to build on these efforts within the context of the Implementation Plan for the National Aboriginal and Torres Strait Islander Health Plan 2013–2023.

Today Health Ministers discussed four roadmaps to be a framework to deliver collaborative policies and programs to address this key health challenge. Ministers committed to working jointly to ending rheumatic heart disease and avoidable blindness and deafness.

Ministers referred the roadmaps to the Australian Health Ministers’ Advisory Council for review and reporting back in November 2019.

2.1 Renal Health 

Aboriginal and Torres Strait Islander people experience a disproportionate burden of renal disease. Research shows non-Indigenous patients are nearly four times more likely to receive kidney transplants, and Indigenous people are nine times as likely to rely on dialysis.

Ministers noted the Renal Health Roadmap, developed by the Commonwealth in conjunction with key stakeholders, as a framework to deliver collaborative policies and programs.

2.2 Eye Health 

The rate of vision impairment and blindness in Aboriginal and Torres Strait Islander people is three times higher than non-Indigenous Australians. The leading causes of vision loss and blindness in Indigenous adults are uncorrected refractive error, cataract and diabetic retinopathy. Ministers noted the Eye Health Roadmap as a framework to deliver collaborative policies and programs.

Vision 2020 Press Release

Vision 2020 Australia welcomes the leadership shown by the Minister for Indigenous Health Ken Wyatt AM, along with his state and territory counterparts, in discussing Aboriginal and Torres Strait Islander eye health and vision at today’s COAG Health Council Meeting.

Too many Aboriginal and Torres Strait Islander people still experience avoidable vision loss and blindness, and those who have lost vision often find it difficult to access the support and services they need.

Our members are working hard to improve eye care for Aboriginal and Torres Strait Islander people, and the plan discussed today is a product of their extensive input and expertise.

We encourage all governments, all sides of politics, and the many others involved in this area to work closely with Aboriginal and Torres Strait Islander communities and their organisations to achieve and sustain real improvements in eye health and vision for Aboriginal and Torres Strait Islander people across our nation.

Aboriginal and Torres Strait Islander people’s eye health – key facts

  • Cataract is the leading cause of blindness for Aboriginal and Torres Strait Islander adults and is 12 times more common than for non-Indigenous Australians.
  • Aboriginal and Torres Strait Islander people wait on average 63% longer for cataract surgery than non-Indigenous Australians.
  • Almost two-thirds of vision impairment among Aboriginal and Torres Strait Islander people is due to uncorrected refractive error – often treatable with a pair of glasses.
  • One in 10 Aboriginal and Torres Strait Islander adults has Diabetic Retinopathy, which can lead to irreversible vision loss.
  • Australia is the only developed country to still have Trachoma, found predominately in Aboriginal and Torres Strait Islander communities.

2.3 Rheumatic Heart Disease 

Rheumatic heart disease is a disease of disadvantage that affects primarily Aboriginal and Torres Strait Islander communities. It is caused by an episode or recurrent episodes of acute rheumatic fever where the heart valves remain stretched or scarred, interrupting normal bloodflow. The Roadmap has used the best available evidence to identify priority actions for the next 10 years.

RHD Press Release

We welcome the COAG Health Council’s commitment to the RHD Roadmap today. The RHD Roadmap was developed by the National Aboriginal Community Controlled Health Organisation (NACCHO) on behalf of END RHD.

We look forward to supporting the AHMAC review of the RHD Roadmap, and ask that the National RHD Steering Committee – which underpins governance of the RHD Roadmap – be convened as a matter of priority to oversee development of the implementation plan.

We look forward to working with the Commonwealth and jurisdictional governments, implementing organisations, and communities, to ensure the RHD Roadmap is implemented in a timely, consultative manner, in line with the COAG Implementation Principles as informed by Aboriginal and Torres Strait Islander Communities.

We thank Ministers Wyatt and Hunt for commissioning and championing the RHD Roadmap. We thank all our partners who contributed their experience, wisdom, and energies in preliminary consultation.

Our goal is to end rheumatic heart disease in Australia. This RHD Roadmap provides a critical opportunity for Aboriginal and Torres Strait Islander people to lead the way to achieve that shared vision.

2.4 Hearing Health

Hearing loss is a complex issue that affects millions of Australians. It is often considered a hidden or invisible issue as, despite the high prevalence of hearing loss, there is limited awareness in the broader community. There is a disproportionate impact on Aboriginal and Torres Strait Islander people due to ear disease that profoundly affects their life experiences through childhood and into adulthood. This has a significant impact on community engagement, education, employment and engagement with the criminal justice system. The Roadmap sets out the short, medium and long-term actions to address the key hearing health issues that have been identified.

3. Diseases of housing overcrowding and poverty in remote Aboriginal and Torres Strait Islander communities

Health Ministers discussed the conditions that make up the health gap for Aboriginal and Torres Strait Islander people and are associated with a range of social and environmental determinants. Communicable diseases in particular share the same environmental risk factors of poor cleanliness and hygiene, the impacts of which are exacerbated by overcrowded living conditions. Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) are two examples of diseases resulting from overcrowding and poverty in remote Aboriginal and Torres Strait Islander communities.

Other Issues 

National Health Reform Agreement – Resolving reconciliation and back casting

Health Ministers discussed differing approaches to the application of back casting in the Activity Based Funding model for Commonwealth funding to states and territories under the National Health Reform Agreement.

State and Territory Ministers will develop a joint set of policy principles and directions on a clear methodology for the calculation of hospital funding for use by the national funding bodies, which will be presented to COAG by June 2019.

Australian National Breastfeeding Strategy: 2019 and Beyond

The World Health Organization’s (WHO) global nutrition target is to increase the rate of exclusive breastfeeding in the first six months up to at least 50 percent by 2025. Low breastfeeding rates and the use of infant formula within the first year of life are linked to obesity and other chronic diseases in later life.

In 2016, Health Ministers agreed to develop an enduring breastfeeding strategy following the conclusion of the Australian National Breastfeeding Strategy 2010-2015. The latest National Health Survey data shows that only around 25% of babies are exclusively breastfed to around six months.

The Australian National Breastfeeding Strategy: 2019 and Beyond seeks to achieve the World Health Organization target of 50% of babies exclusively breastfed to around six months by 2025, including a particular focus on those from priority populations and vulnerable groups. To achieve this objective, actions are proposed across three priority areas: structural enablers; settings that enable breastfeeding; and individual enablers.

Ministers discussed the Australian National Breastfeeding Strategy: 2019 and Beyond and committed to provide a supportive and enabling environment for breastfeeding mothers, infants and families. Ministers were of the view that investing in breastfeeding is an investment in chronic disease prevention and better health.

The Commonwealth Department of Health will lead national policy coordination, monitoring and evaluation and report annually on implementation progress to the Australian Health Ministers’ Advisory Council.

Professional Indemnity Insurance for Privately Practicing Midwives

In 2010, the introduction of the Health Practitioner Regulation National Law Act 2009 saw the requirement for registered health practitioners to have appropriate professional indemnity insurance in place. Despite exhaustive national and international investigations, no available or affordable commercial product in Australia covers Privately Practicing Midwives for homebirth.

Health Ministers considered the issue of professional indemnity insurance for privately practicing midwives. Health Ministers emphasised that the safety of mothers and their babies is paramount.

Health Ministers recognised that the availability of a suitable professional indemnity insurance product covering private home births would be preferable, as it would allow privately practicing midwives to remain registered under the National Law without the need for an exemption, continue to provide choice to women and take into account the rights of women and children.

In the absence of a suitable professional indemnity insurance product for privately practicing midwives, Health Ministers requested that AHMAC would complete additional work to inform the decision of Ministers in relation to the way forward by June 2020.

Health Ministers agreed for the current exemption under the National Law to be extended until December 2021 to allow time for options to be explored further.

Update on ageing and aged care matters including the Royal Commission into Aged Care Quality and Safety

All Australian Health Ministers are committed to the highest quality care for older Australians.

The Minister for Indigenous Health and Minister for Senior Australians and Aged Care, the Hon Ken Wyatt MP, provided an update on recent ageing and aged care initiatives, announcements and the Royal Commission into Aged Care Quality and Safety.

The Royal Commission has a broad scope to inquire into all forms of Commonwealth-funded aged care services, regardless of the setting in which those services are delivered. It will look at the aged care sector as a whole, including younger people with disabilities living in residential age care.

Ministers also discussed a range of issues relating to safe and quality care for older Australians, for example, the provision of primary and community care services to aged care consumers, access to acute care and rehabilitation services, timely movement of consumers from hospital to aged care services and engagement on the implementation of effective mechanisms to regulate restraint in aged care.

Update on National Missions under the Medical Research Future Fund 

National Medical Research Future Fund Missions are large programs of work with ambitious objectives to address complex and sizeable health issues that are only possible through significant investment, leadership and collaboration. They bring together key researchers, health professionals, stakeholders, industry partners, patients and governments to tackle significant health challenges, for example brain cancer and dementia.

Today Health Ministers received an update from the Commonwealth Minister for Health on the five national Missions and the Indigenous Health Futures announced to date and increased opportunities for contestable grant rounds to support health and medical research.

The five missions are

  1. Australian Brain Cancer Mission
  2. Genomics Health Futures Mission
  3. Million Minds Mental Health Research Mission
  4. Dementia, Ageing and Aged Care Research Mission
  5. Mission for Cardiovascular Health

The research work also includes the Indigenous Health Futures for which $160 million from the MRFF has been committed over ten years for a national research initiative to improve the health of Aboriginal and Torres Strait Islander people.

Health Ministers supported the work of the research Missions and the Indigenous Health Futures, agreeing to work together towards achieving their aims.

Resolving outstanding National Disability Insurance Scheme (NDIS) implementation issues

Health Ministers acknowledged the significant efforts being made by all jurisdictions to resolve issues that arise from the interface between the NDIS and health systems.

Mental Health Services

States and territories expressed concerns about access to necessary primary care mental health services. States, territories and the Commonwealth will work constructively so that access to primary mental health services is improved particularly for consumers outside the NDIS.

Regulation of misleading public health information

The Queensland Health Minister provided an update on regulation of misleading public health information in relation to misleading or inaccurate information regarding vaccines or vaccination programs.

Ministers welcomed the prompt action and leadership of the Outdoor Media Association to apply the intent of the Therapeutic Goods Advertising Code (No.2) 2018, so that advertising connected to therapeutic goods ‘must not be inconsistent with current public health campaigns.’

Tobacco industry issues

Australia has been a world leader in legislation restricting the promotion and advertising of tobacco-related products through sport, and in taking a precautionary approach to the control of smoke-free products such as e-cigarettes.

The tobacco industry is investing heavily in smoke-free products and has established associated sports sponsorships launched at the start of the 2019 F1 and MotoGP championship seasons, presenting a challenge to tobacco control legislation.

Victoria raised the issue that e-liquids for use in e-cigarettes are not in child safe packaging, do not contain sufficient warnings and may be dangerous or fatal for young children.

Health Ministers today discussed a national approach to the prohibition of smoke-free,  e-cigarette and related sponsorship and advertising in sport, based on existing tobacco control principles and legislation. This approach will have the capacity to respond to emerging products and forms of marketing.

Health Ministers also noted that the Clinical Principal Committee will develop options to better regulate e-cigarettes and related products including consideration of the need to introduce child proof lids and plain packaging, with options to be provided to the COAG Health Council for consideration.

National Medical Workforce Strategy

A National Medical Workforce Strategy is necessary to guide long-term, collaborative medical workforce planning across Australia.

The Strategy will match the supply of general practitioners, medical specialists and consultant physicians to predicted medical service needs and will involve consultation with a range of stakeholders. Health Ministers will fund the development of a National Medical Workforce Strategy. This will include sharing of data across Commonwealth and other jurisdictions to support the strategy.

It is expected that the Strategy will address several system-level issues including:

  • the number and distribution of specialist training positions and how these might be better aligned to community needs
  • access to the full range of medical services, including maternity services, in regional, rural and remote areas
  • the current reliance on overseas trained doctors to fill specific workforce shortages and how Australia can improve self-sufficiency in medical workforce development
  • integration of medical care between settings and professions
  • improving workplace culture and doctor wellbeing
  • the under-representation of Aboriginal and Torres Strait Islander doctors in the medical workforce.

A Steering Committee has been established under the National Medical Training Advisory Network to guide this work.

Options for a nationally consistent approach to the regulation of spinal manipulation on children 

Health Ministers noted community concerns about the unsafe spinal manipulation on children performed by chiropractors and agreed that public protection was paramount in resolving this issue.

Ministers welcomed the advice that Victoria will commission an independent review of the practice of spinal manipulation on children under 12 years, and the findings will be reported to the COAG Health Council, including the need for changes to the National Law.

Ministers supported the examination of an increase in penalties for advertising offences, such as false, misleading or deceptive advertising, under the Health Practitioner Regulation National Law, to bring these into line with community expectations and penalties for other offences under the National Law. This decision was informed by recent consultation about potential reforms to the National Law in 2018.

Ministers will consider the outcomes of the independent review and determine any further changes needed to protect the public.

 

 

NACCHO Aboriginal Health #Saveadate Events and Conferences : This week features 8 March #InternationalWomensDay #MorePowerfulTogetherand March 3- 9 #WorldHearingWeek and #HearingAwarenessWeek

This weeks featured NACCHO SAVE A DATE events

March 9 International Women’s Day #IWD

Download the 2019 Health Awareness Days Calendar 

9 March  Bush to Beach Project Grazing Style Light Indigenous Marathon Fundraiser

12- 13 March Overcoming Indigenous Family Violence 

14 March Workshop Brisbane Moving Beyond the Frontline project 

14 – 15 March 2019 Close the Gap for Vision by 2020 – National Conference 2019

21 March National Close the Gap Day

21 March Indigenous Ear Health Workshop Brisbane

22 March : The experts priorities for the 2019 Federal Election 

24 -27 March National Rural Health Alliance Conference

20 -24 May 2019 World Indigenous Housing Conference. Gold Coast

18 -20 June Lowitja Health Conference Darwin

2019 Dr Tracey Westerman’s Workshops 

7 -14 July 2019 National NAIDOC Grant funding round opens

23 -25 September IAHA Conference Darwin

24 -26 September 2019 CATSINaM National Professional Development Conference

5-8 November The Lime Network Conference New Zealand 

Featured Save date

March 9 International Women’s Day #IWD

International Women’s Day (IWD) will be celebrated on 8 March across all our 302 Aboriginal community controlled health clinics and 8 affiliates , where thousands of Aboriginal and Torres Strait Islander woman are involved daily in all aspects and levels of comprehensive Aboriginal primary health care delivery.

Professional and dedicated Indigenous Woman CEO’S , Doctors, Clinic Managers, Aboriginal Health Workers , Nurses, Receptionists etc.

We honour all the woman working in our #ACCHO’s over 45 years in #NT #NSW #QLD #WA #SA #VIC #ACT #TAS

VIEW NACCHO Tribute first published 2018

IWD is a global day celebrating the social, economic, cultural and political achievements of women.

Australia’s IWD 2019 theme, More Powerful Together, recognises the important role we all play – as women, men, non-binary and gender diverse people. It takes all of us, working in collaboration and across that which sometimes divides us, breaking down stereotypes and gendered roles to create a world where women and girls everywhere have equal rights and opportunities.

More Powerful Together is a clarion call to stand in unison for gender equality.

AIATSIS : Have you ordered your International Women’s Day poster yet?

This year’s features a wonderful portrait of the much loved and respected Yolŋu leader, Laurie Baymarrwaŋa.

We have limited numbers of the poster available to order, while stocks last

REQUEST HERE 

March 3-9 March Hearing Awareness Week

We are super excited to launch our in celebration of !

We’re calling on all Australians to take the first step toward healthy hearing by joining us. Check your hearing online now:

Part 2 Pictured above 

Sound Scouts is proud to participate in Hearing Awareness Week  from the 3rd to the 9th of March, 2019.  Thanks to Australian Hearing and funding from the Australian Government, you can download the app for free and test your child today.

Sound Scouts is the children’s hearing check designed to make testing easy. Sound Scouts incorporates the science of a hearing test in a fun game. The children don’t even know they are being tested.

Developed in collaboration with the National Acoustic Laboratories, Sound Scouts provides an instant report and guidance on next steps if a problem is detected.

EASY SETUP

Fun app-based test delivering an immediate report.

PROVEN

Published in the International Journal of Audiology, and recommended by
Australian Hearing.

AWARD WINNING

Highly recognised and  supported by NSW Health.

Hearing issues are a common cause of speech, learning and behavioural problems so it is important for all children to have their hearing tested. If a child struggles to hear, they’ll also struggle to learn. The World Health Organisation recommends children have their hearing tested when they start school*.

1 in 10 children are held back at school by hearing loss. Take action to ensure your child isn’t one of them.

WEBSITE 

Download the NACCHO 2019 Calendar Health Awareness Days

For many years ACCHO organisations have said they wished they had a list of the many Indigenous “ Days “ and Aboriginal health or awareness days/weeks/events.

With thanks to our friends at ZockMelon here they both are!

It even has a handy list of the hashtags for the event.

Download the 53 Page 2019 Health days and events calendar HERE

naccho zockmelon 2019 health days and events calendar

We hope that this document helps you with your planning for the year ahead.

Every Tuesday we will update these listings with new events and What’s on for the week ahead

To submit your events or update your info

Contact: Colin Cowell www.nacchocommunique.com

NACCHO Social Media Editor Tel 0401 331 251

Email : nacchonews@naccho.org.au

9 March  Bush to Beach Project Grazing Style Light Indigenous Marathon Fundraiser

The Port Macquarie Running Festival is happening over the weekend of the 9th-10th March 2019. As a part of this event we are running a fundraiser to support the important work being undertaken by Charlie & Tali Maher as a part of the Indigenous Marathon Project Running And Walking group. Come along to hear from Olympians Nova Peris, Steve Moneghette & Robert de Castella while meeting members of the Indigenous Marathon Project over lunch. We hope to see you there.

All funds raised will go towards the Bush to Beach Project. The project aims
to develop a strong relationship between the Northern Territory community of
Ntaria and the coastal community of Port Macquarie, with an exchange program
occurring several times throughout the year. This will include young Indigenous
people visiting the communities and participating in running and walking events
to promote healthy living. We thank you for your support.

Guest Speakers: Olympians Nova Peris, Steve Moneghetti & Robert de Castella.

Any enquiries please get in touch with Nina Cass or Charlie Maher (ninacass87@gmail.com / charles.maher@det.nsw.edu.au)

Tickets $59 Register HERE 

12- 13 March Overcoming Indigenous Family Violence 

Djirra has been chosen to be the charity partner of the next Overcoming Indigenous Family Violence conference organised by Aventedge in Melbourne on the 12th and 13th of March.

On the first day, Tuesday 12th of March, Marion Hansen, Djirra’s chairperson, will give the opening and closing address. At 10.30am, Djirra’s CEO Antoinette Braybrook will share her experience and knowledge on Supporting Aboriginal women, their children and communities to be safe, culturally strong and free from violence.

Family violence against Aboriginal and Torres Strait Islander people, predominantly women and their children, is a national crisis.

Aboriginal and Torres Strait Islander communities and their organisations hold the solutions to ending the disproportionate rates of family violence. However this requires the support and involvement of a range of stakeholders around the country.

The 5th annual Overcoming Indigenous Family Violence Forum (Melbourne & Perth) has partnered with Djirra and brings together representatives from Aboriginal and Torres Strait Islander Community Controlled Organisations, specialist family violence support and prevention services, community legal services, government, police and not-for-profit organisations.

During the course of this conference and 1-day workshop, we will explore critical issues in working to end family violence against Aboriginal and Torres Strait Islander people, including state and federal government initiatives; how frontline services are engaging in prevention, early intervention and response; learning from the stories and experiences of survivors of family violence; working more effectively with people who use violence towards accountability and behaviour change and the impacts of family violence on children and young people.

For more information on these events, pricing and discounts click below:
Melbourne | 12th-14th March 2019
Event homepage – www.ifv-mel.aventedge.com
Register here – http://elm.aventedge.com/ifv-mel-register

Perth | 5th-6th March 2019
Event homepage – www.ifv-per.aventedge.com
Register here – http://elm.aventedge.com/ifv-per/register

14 March Workshop Brisbane Moving Beyond the Frontline project 

An interactive workshop for currently enrolled Aboriginal and Torres Strait Islander health and medical students.

Panel conversations with

Associate Professor Chelsea Bond (UQ Poche)
Associate Professor Shannon Springer (Bond Uni)
Professor Mark Brough (QUT) &
Dr Bryan Mukandi (UQ Medicine)

The workshop shares key findings from the Moving Beyond the Frontline project to facilitate a broader conversation about how to foster culturally safe learning environments for Indigenous health and medical students. 

Aboriginal and Torres Strait Islander students currently enrolled in a health or health related degree program (undergraduate or postgraduate), at any institution, are eligible to attend.

Register by 6 March to secure your place.

Catering will be provided.

** Please note that due to limited capacity, preference is to accomodate Australian Aboriginal and/or Torres Strait Islander students **

For more information about Moving Beyond the Frontline project, visit the Lowitja Institute website or watch a short video about the project here: https://vimeo.com/278096582

For further information about the event, please email UQ Poche at poche@uq.edu.au

REGISTER HERE

14 – 15 March 2019 Close the Gap for Vision by 2020 – National Conference 2019

Indigenous Eye Health (IEH) at the University of Melbourne and co-host Aboriginal Medical Services Alliance Northern Territory (AMSANT), are pleased to invite you to register for the Close the Gap for Vision by 2020:Strengthen & Sustain – National Conference 2019 which will be held at the Alice Springs Convention Centre on Thursday 14 and Friday 15 March 2019 in the Northern Territory. This conference is also supported by our partners, Vision 2020 Australia, Optometry Australia and the Royal Australian and New Zealand College of Ophthalmologists.

The 2019 conference, themed ‘Strengthen & Sustain’ will provide opportunity to highlight the very real advances being made in Aboriginal and Torres Strait eye health. It will explore successes and opportunities to strengthen eye care and initiatives and challenges to sustain progress towards the goal of equitable eye care by 2020. To this end, the conference will include plenary speakers, panel discussions and presentations as well as upskilling workshops and cultural experiences.

Registration (including workshops, welcome reception and conference dinner) is $250. Registrations close on 28 February 2019.

Who should attend?

The conference is designed to bring people together and connect people involved in Aboriginal and Torres Strait Islander eye care from local communities, Aboriginal Community Controlled Health Organisations, health services, non-government organisations, professional bodies and government departments from across the country. We would like to invite everyone who is working on or interested in improving eye health and care for Aboriginal and Torres Strait Islander Australians.

Speakers will be invited, however this year we will also be calling for abstracts for Table Top presentations and Poster presentations – further details on abstract submissions to follow.

Please share and forward this information with colleagues and refer people to this webpage where the conference program and additional informationwill become available in the lead up to the conference. Note: Please use the conference hashtag #CTGV19.

We look forward to you joining us in the Territory in 2019 for learning and sharing within the unique beauty and cultural significance of Central Australia.

Additional Information:

If you have any questions or require additional information, please contact us at indigenous-eyehealth@unimelb.edu.au or contact IEH staff Carol Wynne (carol.wynne@unimelb.edu.au; 03 8344 3984 email) or Mitchell Anjou (manjou@unimelb.edu.au; 03 8344 9324).

Close the Gap for Vision by 2020: Strengthen & Sustain – National Conference 2019 links:

– Conference General Information

– Conference Program

– Conference Dinner & Leaky Pipe Awards

– Staying in Alice Springs

More information available at: go.unimelb.edu.au/wqb6 

21 March National Close the Gap Day

Featured Save date

For the last 10 years many thousands of Australians from every corner of the country, in schools, businesses and community groups, have shown their support for Close the Gap by marking National Close the Gap Day each March.

This National Close the Gap Day, we have an opportunity to send our governments a clear message that Australians value health equality as a fundamental right for all.

On National Close the Gap Day we encourage you to host an activity in your workplace, home, community or school.

Our aim is to bring people together to share information, and most importantly, to take meaningful action in support of achieving Indigenous health equality by 2030.

How to get involved in National Close the Gap Day

  • Register your activity. You can download some online resources to support your event
  • Invite your friends, workmates and family to join you
  • Take action by signing the Close the Gap pledge and asking your friends and colleagues to do the same
  • Call, tweet or write to your local Member of Parliament and tell them that you want them to Close the Gap
  • Listen to and share the stories of Aboriginal and Torres Strait Islander people on Facebook – visit our Close the Gap Facebook page.
  • Share your photos and stories on social media. Use the hashtag #ClosetheGap
  • Donate to help our work on Close the Gap

With events ranging from workplace morning teas, sports days, school events and public events in hospitals and offices around the country — tens of thousands of people take part each year to make a difference.

Your actions can create lasting change. Be part of the generation that closes the gap.

National Close the Gap Day is a time for all Australians to come together and commit to achieving health equality for Aboriginal and Torres Strait Islander people.

The Close the Gap Campaign will partner with Tharawal Aboriginal Aboriginal Medical Services, South Western Sydney, to host an exciting community event and launch our Annual Report.

Visit the website of our friends at ANTaR for more information and to register your support. https://antar.org.au/campaigns/national-close-gap-day

EVENT REGISTER

21 March Indigenous Ear Health Workshop Brisbane 

The Australian Society of Otolaryngology Head and Neck Surgery is hosting a workshop on Indigenous Ear Health in Brisbane on Thursday, 21 March 2019.

This meeting is the 7th to be organised by ASOHNS and is designed to facilitate discussion about the crucial health issue and impact of ear disease amongst Indigenous people.

The meeting is aimed at bringing together all stakeholders involved in managing Indigenous health and specifically ear disease, such as:  ENT surgeons, GPs, Paediatricians, Nurses, Audiologists, Speech Therapists, Allied Health Workers and other health administrators (both State and Federal).

Download Program and Contact 

Indigenous Ear Health 2019 Program

22 March : The experts priorities for the 2019 Federal Election 

Listen to 3 of Australia’s leading health advocates outline their top priorities for change

– Book Here

24 -27 March National Rural Health Alliance Conference

Interested in the health and wellbeing of rural or remote Australia?

This is the conference for you.

In March 2019 the rural health sector will gather in Hobart for the 15th National Rural Conference.  Every two years we meet to learn, listen and share ideas about how to improve health outcomes in rural and remote Australia.

Proudly managed by the National Rural Health Alliance, the Conference has a well-earned reputation as Australia’s premier rural health event.  Not just for health professionals, the Conference recognises the critical roles that education, regional development and infrastructure play in determining health outcomes, and we welcome people working across a wide variety of industries.

Join us as we celebrate our 15th Conference and help achieve equitable health for the 7 million Australians living in rural and remote areas.

Hobart and its surrounds was home to the Muwinina people who the Alliance acknowledges as the traditional and original owners of this land.  We pay respect to those that have passed before us and acknowledge today’s Tasmanian Aboriginal community as the custodians of the land on which we will meet.

More info 

20 -24 May 2019 World Indigenous Housing Conference. Gold Coast

Thank you for your interest in the 2019 World Indigenous Housing Conference.

The 2019 World Indigenous Housing Conference will bring together Indigenous leaders, government, industry and academia representing Housing, health, and education from around the world including:

  • National and International Indigenous Organisation leadership
  • Senior housing, health, and education government officials Industry CEOs, executives and senior managers from public and private sectors
  • Housing, Healthcare, and Education professionals and regulators
  • Consumer associations
  • Academics in Housing, Healthcare, and Education.

The 2019 World Indigenous Housing Conference #2019WIHC is the principal conference to provide a platform for leaders in housing, health, education and related services from around the world to come together. Up to 2000 delegates will share experiences, explore opportunities and innovative solutions, work to improve access to adequate housing and related services for the world’s Indigenous people.

Event Information:

Key event details as follows:
Venue: Gold Coast Convention and Exhibition Centre
Address: 2684-2690 Gold Coast Hwy, Broadbeach QLD 4218
Dates: Monday 20th – Thursday 23rd May, 2019 (24th May)

Registration Costs

  • EARLY BIRD – FULL CONFERENCE & TRADE EXHIBITION REGISTRATION: $1950 AUD plus booking fees
  • After 1 February FULL CONFERENCE & TRADE EXHIBITION REGISTRATION $2245 AUD plus booking fees

PLEASE NOTE: The Trade Exhibition is open Tuesday 21st May – Thursday 23rd May 2019

Please visit www.2019wihc.com for further information on transport and accommodation options, conference, exhibition and speaker updates.

Methods of Payment:

2019WIHC online registrations accept all major credit cards, by Invoice and direct debit.
PLEASE NOTE: Invoices must be paid in full and monies received by COB Monday 20 May 2019.

Please note: The 2019 WIHC organisers reserve the right of admission. Speakers, programs and topics are subject to change. Please visit http://www.2019wihc.comfor up to date information.

Conference Cancellation Policy

If a registrant is unable to attend 2019 WIHC for any reason they may substitute, by arrangement with the registrar, someone else to attend in their place and must attend any session that has been previously selected by the original registrant.

Where the registrant is unable to attend and is not in a position to transfer his/her place to another person, or to another event, then the following refund arrangements apply:

    • Registrations cancelled less than 60 days, but more than 30 days before the event are eligible for a 50% refund of the registration fees paid.
    • Registrations cancelled less than 30 days before the event are no longer eligible for a refund.

Refunds will be made in the following ways:

  1. For payments received by credit or debit cards, the same credit/debit card will be refunded.
  2. For all other payments, a bank transfer will be made to the payee’s nominated account.

Important: For payments received from outside Australia by bank transfer, the refund will be made by bank transfer and all bank charges will be for the registrant’s account. The Cancellation Policy as stated on this page is valid from 1 October 2018.

Terms & Conditions

please visit www.2019wihc.com

Privacy Policy

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18 -20 June Lowitja Health Conference Darwin


At the Lowitja Institute International Indigenous Health and Wellbeing Conference 2019 delegates from around the world will discuss the role of First Nations in leading change and will showcase Indigenous solutions.

The conference program will highlight ways of thinking, speaking and being for the benefit of Indigenous peoples everywhere.

Join Indigenous leaders, researchers, health professionals, decision makers, community representatives, and our non-Indigenous colleagues in this important conversation.

More Info 

2019 Dr Tracey Westerman’s Workshops 

More info and dates

7 -14 July 2019 National NAIDOC Grant funding round opens 

The opening of the 2019 National NAIDOC Grant funding round has been moved forward! The National NAIDOC Grants will now officially open on Thursday 24 January 2019.

Head to www.naidoc.org.au to join the National NAIDOC Mailing List and keep up with all things grants or check out the below links for more information now!

https://www.finance.gov.au/resource-management/grants/grantconnect/

https://www.pmc.gov.au/indigenous-affairs/grants-and-funding/naidoc-week-funding

23 -25 September IAHA Conference Darwin

 

24 -26 September 2019 CATSINaM National Professional Development Conference

 

 

The 2019 CATSINaM National Professional Development Conference will be held in Sydney, 24th – 26th September 2019. Make sure you save the dates in your calendar.

Further information to follow soon.

Date: Tuesday the 24th to Thursday the 26th September 2019

Location: Sydney, Australia

Organiser: Chloe Peters

Phone: 02 6262 5761

Email: admin@catsinam.org.au

 

5-8 November The Lime Network Conference New Zealand 

This years  whakatauki (theme for the conference) was developed by the Scientific Committee, along with Māori elder, Te Marino Lenihan & Tania Huria from .

To read about the conference & theme, check out the  website. 

NACCHO Aboriginal Health Research : Ministers @GregHuntMP and @KenWyattMP announce $160 million funding for Indigenous health research over 10 years targeting three flagship priorities and five key areas

“It is time to come together as a nation to work as partners in bringing equity in health outcomes”

The right research into improved treatments and services has the potential to dramatically accelerate the progress we have seen over the last six years in achieving better health for Indigenous Australians,”

Minister for Indigenous Health, Ken Wyatt AM

The fund is a vital step towards improving the health of our Aboriginal and Torres Straits Islander communities. Ultimately, parity in health outcomes is the only acceptable goal, and this fund will help to achieve it.

The research into improving the system is critical, but we are also absolutely committed to delivering real, on-the-ground improvements and frontline services right now “

Health Minister Greg Hunt

” It is a great honour to be asked to co-chair this critical research platform for the future.  Health and social inequity as experienced by Indigenous Australians stands as one of our nations great challenges.  Only through dedicated, collaborative, adequately resourced action, led by community priorities and processes can we hope to make meaningful change. 

Our collective job is to unlock the expertise and capabilities of the Indigenous community, backed the brightest and most gifted scientists and medical researchers and their institutions to make a more equitable future for all Australians.”

Professor Alex Browne : South Australian Health and Medical Research Institute

The Federal Government will provide $160 million for a national research initiative to improve the health of Aboriginal and Torres Strait Islander people.

The Indigenous Health Research Fund will be a 10-year research program funded from the Medical Research Future Fund (MRFF).

It will support practical, innovative research into the best approaches to prevention, early intervention, and treatment of health conditions of greatest concern to Indigenous communities.

First three flagship priorities

The funding’s first three flagship priorities, which aim to deliver rapid solutions to some of the biggest preventable health challenges faced by our First Nations peoples, are:

  • Ending avoidable blindness
  • Ending avoidable deafness
  • Ending rheumatic heart disease

Minister for Indigenous Health, Ken Wyatt AM announced the first project to be funded under the Indigenous Health Research Fund on Sunday – $35 million for the development of a vaccine to eliminate rheumatic heart disease in Australia.

Rheumatic heart disease is a complication of bacterial infections of the throat and skin. Australia currently has the highest rate of rheumatic heart disease in the world.

Every year, nearly 250 children are diagnosed with acute rheumatic fever and 50 – 150 people die from rheumatic heart disease in Australia. Aboriginal and Torres Strait Islander people are 64 times more likely than non-Indigenous people to develop rheumatic heart disease, and nearly 20 times as likely to die from it.

“Rheumatic heart disease kills young people and devastates families. This funding will save countless lives in Australia and beyond,” Health Minister Greg Hunt said.

Five key areas of Research

The remaining $125 million Indigenous Health Research funding will be focussed on research projects that fall into five key areas – guaranteeing a healthy start to life, improving primary health care, overcoming the origins of inequality in health, reducing the burden of disease, and addressing emerging challenges.

An advisory panel comprising prominent Indigenous research experts and community leaders, cochaired by Prof. Alex Browne (South Australian Health and Medical Research Institute) and Prof. Misty Jenkins (Walter and Eliza Hall Institute of Medical Research), will guide the Indigenous Health Research Fund investments.

It will be the first national research fund led by Indigenous people, and conducted with close engagement with Indigenous communities.

The Indigenous Health Research Fund will also seek contributions from philanthropic organisations, state governments, industry, and the private sector in order to increase the reach and impact of the fund.

The Indigenous Health Research Fund will provide the knowledge and understanding to make health programs for Aboriginal and Torres Strait Islander people more effective and lead to lasting health improvements.

This is key to closing the gap in health outcomes since, despite considerable investment by the Commonwealth in existing programmes, Indigenous Australians currently have about a 10 year lower life expectancy and 2.3 times the burden of disease compared to non-Indigenous Australians.

The Morrison Government will provide separate funding of $3.8 million over four years to fund the University of Melbourne’s Indigenous Eye Health Program. This program aims to improve Indigenous eye health in Australia.

“The research into improving the system is critical, but we are also absolutely committed to delivering real, on-the-ground improvements and frontline services right now,” Minister Hunt said.

Our  Government has a long-standing and important commitment to achieving health equity between Indigenous and non-Indigenous Australians.

The Government is investing $3.9 billion in Indigenous-specific health initiatives (from 2018-19 to 2021-22), an ongoing increase of around four per cent per year. This includes investment under the Indigenous Australians’ Health Program.

The MRFF is key to the Government’s health and research plans and is delivering significant benefits for Australian researchers, with over $2 billion in disbursements announced to date

 NACCHO Aboriginal Hearing Health : #OMOZ2018 Ear Health Project Officers will spearhead a new $7.9 million #HearingforLearning program to fight hearing loss among Aboriginal and Torres Strait Islander childre

Hearing for Learning aims to dramatically lift the capacity for communities to identify ear disease within the first few months of life.

Infants rarely show signs of ear pain, so infections are not detected and diseases like otitis media persist and progress.

By 12 months of age, only five per cent of First Nations children in remote communities have bilateral normal hearing, compared with over 80 per cent of children in the rest of Australia.

Children with undiagnosed hearing loss tend to fall behind at school due to delayed speech and language development.

This can have a huge impact on their early years, future employment opportunities and their chance of a happy and successful life.”

Indigenous Health Minister Ken Wyatt AM

The Territory Labor Government promised to put children at the centre of our decision-making, because we want a brighter future for our kids – a future filled with opportunity.

When we focus on the first 1000 days of a child’s life, we know we get better outcomes for their future, and that’s what this partnership aims to do.

Hearing health has an enormous impact on a child’s development, and by addressing this at a community level, the entire community will benefit.” 

NT Chief Minister Michael Gunner

Watch video 

 

Read over 40 Aboriginal Ear and Hearing articles published by NACCHO over last 6 years

Hearing is essential for strong early childhood development and chronic hearing problems in children cause education difficulties leading to entrenched disadvantage.

The Hearing for Learning Initiative is a ground-breaking 5-year investment combining public and private funding to solve this serious health and education problem “

Professor Alan Cass Director Menzies School of Health Research

When we learned about the chronic nature of ear disease in children living in remote communities in the Northern Territory, we could not ignore the fact that this likely leads to profound disadvantage in health, education and employment outcomes.

We believe more must be done and the next step is to support the community to deliver a solution.

Philanthropy plays a unique role in recognising and piloting new approaches, however, it requires partnership with government to deliver these approaches at scale.

The Government is to be applauded for putting this unique partnership together to solve what has now become a serious epidemic.

Neil Balnaves AO, Founder, The Balnaves Foundation and Chancellor, Charles Darwin University

Dozens of local Ear Health Project Officers will spearhead a new $7.9 million program to fight hearing loss among Aboriginal and Torres Strait Islander children in the Northern Territory.

The Hearing for Learning initiative will be established in 20 urban, rural and remote sites, where up to 40 local people will strengthen and complement the work of fly-in fly-out (FIFO) ear specialists.

“This is an exciting new opportunity to remove the preventable blight of hearing loss from current and future generations,” said Indigenous Health Minister Ken Wyatt AM.

“These local ear health warriors will integrate with existing primary care services, to help protect the hearing of up to 5,000 children from birth to 16 years old.

“Lifting the capacity of local families to recognise, report and treat ear problems early promises to help our children reach their full potential.”

The initiative will be implemented by the Menzies School of Health Research and co-led by Professor Amanda Leach and Associate Professor Kelvin Kong.

The Hearing for Learning is a ground-breaking 5-year initiative by the Northern Territory Government, founded on scientific research by Northern Territory scientists at Menzies School of Health Research, combining public and private funding to solve this serious health and education problem.

$2.4 million from NT Government

$2.5 million from The Balnaves Foundation

$3 million from the Federal Government

Hearing for Learning aims to dramatically lift the capacity for communities to identify ear disease within the first few months of life,” said Minister Wyatt.

“Infants rarely show signs of ear pain, so infections are not detected and diseases like otitis media persist and progress.

“By 12 months of age, only five per cent of First Nations children in remote communities have bilateral normal hearing, compared with over 80 per cent of children in the rest of Australia.”

“Children with undiagnosed hearing loss tend to fall behind at school due to delayed speech and language development,” Minister Wyatt said.

“This can have a huge impact on their early years, future employment opportunities and their chance of a happy and successful life.”

The Menzies School of Health Research aims to make Hearing for Learning a care model that can be replicated across the nation.

Hearing for Learning will complement the Government’s existing ear health programs, including Healthy Ears, which together will receive funding of $81.8 million over four years from 2018–19.

This includes $30 million for a new outreach program to provide annual hearing assessment, referral and follow-up treatment for Aboriginal and Torres Strait Islander children before they start school.

NACCHO Aboriginal #Hearing Health News : 1.⁦⁦⁩#Earhealthforlife 2. Delegates gather for #OMOZ2018 to help close the hearing gap 3. #Hearing #Mentalhealth #communications

” The Otitis Media Australia Conference (OMOZ) this week in Darwin will attract Australia’s leading ear health investigators.

Darwin is a significant location for @OMOZ_2018 as the NT has the highest recorded prevalence of otitis media in the world, up to 90% of children in some communities.

OMOZ provides a forum for all researchers, clinical practitioners, health workers, policy makers, audiologists, speech therapists, ENT surgeons, consumers, educators and primary health care services investigating the prevention and treatment of chronic ear disease and hearing loss in Australia. “

See Part 1 Below to Download full OMOZ 2018 Program 

Conference Website

Read over 40 NACCHO Ear health and hearing articles

 ” The #EarHealthForLife network is committed to a national Aboriginal and Torres Strait Islander Hearing Health Taskforce that can provide evidence-based advice to Government about hearing health. Recognising the extent of missing data and inconsistent metrics on hearing health acrossAustralia, we are also committed to better embedding hearing health in the Closing the Gap targets and associated strategies, and an agreed national standard “

 Part 2 Download Here : Ear Health for Life Booklet A national approach to monitoring ear health

2018-05-15_earhealthforlife_booklet

 “Hearing loss is widespread among Indigenous people because of endemic childhood ear disease. This hearing loss has been described by a senate enquiry as ‘the missing piece of the puzzle in Indigenous disadvantage’[20]. This article seeks to explore a too long neglected issue that, when addressed, has the capacity to improve life outcomes for many Indigenous Australians.

The neglect of this issue in part arises because these communication issues are not‘visible’to those affected or those they communicate with. The hearing loss happens so early and so pervasively that is often ‘normalised’ among those affected.

These origins of communications problems are often obscured by a focus on cross cultural differences as sufficient explanation of communication difficulties that are evident. Most mental health workers are currently ill equipped to understand the communicative needs of people with listening difficulties and the common consequential psycho-social problems.”

Howard D, Barney J (2018) Minced words: the importance of widespread hearing loss as an issue in the mental health of Indigenous Australians. Read Extracts part 3 Below 

Part 1 Download Program 

OMOZ 2018 Program pdf

The conference provides an opportunity to share and learn about the latest evidence-based research and best practice treatment and prevention methods. All aspects of science, public health, policy, pathology, surgery, technology, hearing services, education and community engagement will find an audience. Indigenous researchers, practitioners and officeholders are encouraged to attend.

OMOZ 2018 is committed to excellence in evidence-based research and practice to reduce rates of otitis media and hearing loss in Australia.  This biannual conference encourages innovation by collaborating to find new approaches to solving this problem.

Part 3 Introduction

Download full Paper HERE

bulletin_review_howard final

When we think of people who are hard of hearing, we generally think of someone over fifty who has noise-induced hearing loss.

This stereotype is largely accurate for non-Indigenous Australians. Among this group, 85 per cent of people that are hard of hearing are over fifty [1].

The situation is very different for Indigenous Australians. Among them, hearing loss is far more pervasive and occurs across the entire age profile [2]. This is mainly due to the high incidence of middle ear disease among Indigenous children.

One of childhood’s most common illnesses, otitis media often causes conductive hearing loss [3].

This condition may be temporary, but when it recurs persistently, the cumulative total of time that children spend with ear disease can be substantial.

Crucially, the associated hearing loss occurs during critical periods of development in auditory, cognitive and psycho-social competencies [4, 5].

Persistent ear disease can damage the middle ear structures in ways that result in some degree of permanent mild-to-moderate conductive hearing loss [3]. Thus, from very early on in children’s lives otitis media can result in fluctuating mild-to-moderate levels of hearing loss, auditory processing problems and even permanent hearing loss. Individually and in combination, these impacts can have adverse effects on the psycho-social development of a child, with significant lifelong consequences.

Conversely, people who experience hearing problems later in life have already acquired their language skills, coped with schooling and completed major stages of their family and occupational life. When children experience early onset hearing problems, their cognitive and psycho-social development and subsequent engagement in family life, education and employment can all be affected. The younger the age at which hearing loss occurs, the greater the impacts across life [4, 6].

A common consequence of frequent mild to moderate conductive hearing loss from childhood ear disease is auditory processing problems, which can manifest as greater difficulties understanding what is said when it is noisy [7].

Auditory processing has been described as ‘what we do with what we hear’; how the brain processes the sounds perceived. Long periods of fluctuating hearing loss during critical developmental periods can impact markedly on a child’s auditory processing skills development [7]. Auditory processing problems can exist after hearing loss from ear disease has been resolved, or co-exist with permanent hearing loss from persistent ear disease

Acoustic environment

The acoustic environment greatly influences communication outcomes for people with hearing loss and auditory processing problems. In a good listening environment (where the signal being listened to is loud enough to be easily heard and there is little background noise), people with mild listening difficulties may cope almost as well as those with no hearing problems.

In an adverse acoustic environment, however, people with hearing loss and/or auditory processing problems often find it more challenging to understand what is said as compared to others[15].

Thisdiscrepancy in performance can be difficult for others to understand and can give rise, firstly, to people with listening problems thinking they are less intelligent or less competent than others, and, secondly, to others thinking ‘they can hear when they want to’.

That is, they are judged as not motivated to listen or purposefully ignoring what is said. These kinds of damaging judgments can initiate a cascade of social and emotional problems. Children are often excluded from social connections with family and friends, may be blamed and punished for not listening, or develop self-damaging negative beliefs about their own capacity.

Psycho-social outcomes related to early problems understanding what is said

Non-Indigenous people with hearing loss describe experiencing more anxiety, depression and interpersonal problems [8, 9, 10]. Non-Indigenous Australian children with a history of middle ear disease also report more psycho-social problems [11].

Indigenous children and adults have been found to have more behavioural problems [12, 13] and social problems [14], whilst Indigenous adults with listening problems describe higher levels of psychological distress [6]. Many of Indigenous clients working with psychologists will have mild hearing loss and/or auditory processing problems that contribute to their presenting problems. In our experience, often neither the practitioner nor client are aware of this important factor influencing communication and presenting mental health problems. Cross cultural issues often contribute to this invisiblity

Cross-cultural factors obscure hearing problems

Hearing loss and auditory processing problems among Indigenous people are often obscured by a focus solely on cultural differences as sufficient explanation for certain responses; responses that are in fact related to hearing loss and/or auditory processing problems. These include misunderstanding what is said, extreme shyness, taking longer to respond or not responding in conversation

Indigenous people with communication problems related to hearing loss often experience greater difficulties in unfamiliar Western environments. These problems inhibit the ability to learn what is needed in order to operate effectively in non-Indigenous cultural domains [6]. People may avoid engagement with certain non-Indigenous people and contexts because the unfamiliar social processes are challenging.

Regular avoidance of contact with non- Indigenous people and processes thus acts to restrict exposure to cross cultural experiences. Over time, this means that people with hearing problems don’t have the same level of opportunity to develop a better understanding of Western cultural processes.

This regular avoidance and resulting limited cross-cultural understanding means that what begins as difficulties in understanding what is said, evolves into problems fully understanding what is heard and observed in culturally unfamiliar contexts.

An implication of this is that achieving successful engagement with Indigenous people with hearing loss and/or auditory processing problems often requires facilitation by known Indigenous people within familiar cultural processes [12]. Family members and friends are often crucial to interpret and provide communication support to enable successful engagement.

Issues in mental health practice

Widespread hearing loss and auditory processing problems among Indigenous people have a number of implications for mental health practice.

Enabling Compensatory Strengths

There is inevitably a history of negative social experiences as a result of early and frequent hearing loss. A strengths focused approach is generally recommended for work with Indigenous clients [16]. This is especially important to counter the frequent criticisms from others and habitual negative self-perceptions when people have had longstanding difficulties in understanding what is said to them. Helping clients to recognise their strengths, including the compensatory strengths that are commonly developed in response to hearing difficulties can help to create a reframed self-perception. One that is more realistic, positive and resilient. Common compensatory strengths developed include the following.

Visual Observation

People with early onset hearing loss and auditory processing problems often develop sophisticated and astute powers of visual observation. Their skills include lip-reading, face-watching and reading body language, as well as a highly developed capacity to assess attitudinal and emotional reactions from these observations.

These skills develop both from the greater focus on the use of visual cues for communication in Indigenous cultures [17], as well to compensate for the challenges experienced because of listening problems. This means communication with them that is visually rich is more successful.

In addition to exploring and recognising a client’s visual strengths, it can be helpful to make use of these skills for communication during sessions. For example, a practitioner can use visual materials to support explanations of different points; using a white board, or a tablet, or just pen and paper.

Social support

Indigenous cultures foster problem solving through mutual social support. Seeking help to clarify communications by familiar people who can be trusted not to judge or shame is one of the most common coping strategies used by Indigenous people with hearing loss.

Familiarity

Being familiar with people and social processes greatly reduces listening demands. Where one person has established a positive relationship with another, it provides a framework of shared knowledgethatfosterssuccessfuluseofavarietyofcommunication skills.

“You have to know the person to read their expressions, not all mean exactly the same. With new people I can’t judge what they mean, so it’s hard to know when they’re joking, angry, sad, etc. unless I know them.” (Indigenous worker with auditory processing problems) [6, p23].

Anticipation

Being familiar with processes and people, enables people with hearing loss to make assumptions about topics that will be likely talked about. This involves habitually thinking ahead, trying to anticipate what will happen next, what will be said and to plan what they may want to say or ask in response. When they anticipate accurately, conversation is more predictable, and communication becomes more successful.

Anticipation is commonly used to cope with expressive language problems that often co-exist with comprehension problems because of hearing loss and/or auditory processing problems. People are often shamed if put on the spot in a conversation to speak about something. They have difficulties or need more time to formulate what to say. Being judged because of such difficulties in expressing themselves commonly prompts stress and anxiety.

Being able to anticipate what will be talked about helps to avoid being shamed by faltering efforts to express themselves. Expressive language problems related to childhood ear disease should be considered when clients display ‘scripted monologues’ during sessions or meetings. They may talk their way through the monologue, often ignoring or appearing discomfited by interruptions. It may be difficult for them to respond to questions until they have finished their prepared talk.

Avoidance

When dealing with unfamiliar people and unfamiliar processes, people with listening problems often experience anxiety and this can lead to using avoidance tactics to resolve their discomfit. For example, children with hearing loss may not answer a question in class [12, 14] or they may avoid going to school [18]; a patient may not attend an appointment with an unknown medical specialist [19]; or an employee with limited literacy may avoid literacy support training [6]. This type of avoidance limits engagement and the benefits to be gained from greater engagement with schooling, health, training, employment and psychological services.

Avoidance is the least successful of the above coping strategies and often contributes to limiting social, educational and occupational opportunities.

Managing listening overload

Whatever the setting, most psychologists tend to rely on ‘talking therapies’. However, clients who make extensive use of the above cognitively demanding strategies will tire more quickly than others in intensive listening situations – there is a danger of experiencing‘listening overload’. People may listen for a time, then ‘tune-out’, too tired for further effort to understand. At these times, discussions are liable to be experienced as a sequence of poorly understood, disconnected verbal interactions; ‘minced words’. The indication that someone is no longer ‘listening effectively’ is often that ‘face-watching’ ceases and is replaced by an unfocused gaze and minimal or ‘off the topic’ responsiveness.

Overall, it is often helpful to structure talk differently in sessions when working with clients with listening problems. The following list outlines some of these:

* Talk less and about what’s most important.

* Where possible give an overview of what sessions will cover.

* If ‘listening overload’ is evident consider having shorter sessions or including activities that are less demanding on listening capacity.

* Highly visual pre-reading is helpful, if there are no literacy problems.

* Use diagrams and illustrations to help explain.

* Clearly indicate when you are changing the topic of conversation.

* Use language the client knows and consider the experiences that are familiar to them.

* Create pattern and structure in discussions where possible, to help clients anticipate.

* Give the client written notes, (text messages, email or hand written) about what was discussed in the session.

* In group work, give clients forewarning about being asked to speak publicly and on what topic.

* Also in group sessions actively minimise ‘cross talk’, where some participants have private conversations that create background noise that obscures the main conversation.

Therapy techniques that demand minimal listening (EMDR, art therapy) are often more comfortable for clients with listening problems than those that require a lot of listening and talking. Overall, consider that clients with listening problems may like to have clear expectations about what will happen next during sessions, so they can mentally anticipate what may be said to them and what they may like to say. When they know what is ahead they are more likely to return and participate in constructive ways.

The use of hand held amplification devices should also be considered with some clients, if acceptable to them. These are devices about the size of a mobile phone that amplify the speaker’s voice to the client who listens through headphones. These devices are especially useful if discussions do take place in noisy environments. Amplification during any large group presentations, with a microphone that can be handed around, is highly desirable.

Discussion 

Hearing loss is widespread among Indigenous people because of endemic childhood ear disease. This hearing loss has been described by a senate enquiry as ‘the missing piece of the puzzle in Indigenous disadvantage’[20]. This article seeks to explore a too long neglected issue that, when addressed, has the capacity to improve life outcomes for many Indigenous Australians.

The neglect of this issue in part arises because these communication issues are not‘visible’to those affected or those they communicate with. The hearing loss happens so early and so pervasively that is often ‘normalised’ among those affected. These origins of communications problems are often obscured by a focus on cross cultural differences as sufficient explanation of communication difficulties that are evident. Most mental health workers are currently ill equipped to understand the communicative needs of people with listening difficulties and the common consequential psycho-social problems.

This article is one of the first (of hopefully many more to come) focusing on the interrelated communication and psycho-social issues arising from hearing loss and auditory processing problems among Indigenous people in Australia. What is discussed has also has relevance for many others around the world.

Middle ear disease is in large part a disease of disadvantage. It is commonly found around the world in underprivileged communities and in developing nations [23]. However, to date it has been only in ‘first world’ nations that research has mapped the prevalence of middle ear disease and associated hearing loss among disadvantaged Indigenous people. However, similar problems are likely to exist for approximately a billion people worldwide in developing nations [23].

A smaller but significant number of non-Indigenous people in Australia and elsewhere also are likely to have psycho-social problems that have been contributed to by chronic middle ear disease in childhood, or auditory processing problems from other origins. Aside from specific cultural issues described, the information in this article is also relevant for practitioners working with them.

 

 

 

 

NACCHO Media Alerts : Top 10 Current Aboriginal Health News Stories to keep you up to date

1. Aboriginal sexual health: The Australian : Was the syphilis epidemic preventable ? NACCHO responds

2.Royal Flying Doctors Service extra 4-year funding $84 million Mental Health and Dental Services

3.Nurses PAQ continues political membership campaign spreading false and misleading information about our cultural safety

4.AMSANT has called for re-doubled efforts to implement the recommendations of the Royal Commission into the care and protection of children in partnership with NT Aboriginal leaders

5.Dialysis facilities worth $17 million are sitting padlocked, empty and unused in WA’s north

6.ALRC Report into Incarceration of Aboriginal and Torres Strait Islander People.

7. Minister Ken Wyatt : Listening to Indigenous Needs: Healthy Ears Program Extended with $29.4 commitment

8.Tangentyere Alice Springs Women’s Family Safety Group visits Canberra

9.Minister Ken Wyatt launches our NACCHO RACGP National Guide to a preventative health assessment for Aboriginal and Torres Strait Islander people

10. Your guide to a healthy Easter : #Eggs-actly  

 

1.Aboriginal sexual health: The Australian : Was the syphilis epidemic preventable ? NACCHO responds

“These (STIs) are preventable diseases and we need increased testing, treatment plans and a ­culturally appropriate health ­education campaign that focuses resources on promoting safe-sex messages delivered to at-risk ­communities by our trained Aboriginal workforce,”

Pat Turner, chief executive of peak body the National Aboriginal Community Controlled Health Organisation, is adamant about this.

Read full article in Easter Monday The Australian or Part B below

2.Royal Flying Doctors Service extra 4-year funding $84 million Mental Health and Dental Services

Read full press release here

 

3.Nurses PAQ continues political membership campaign spreading false and misleading information about cultural safety

SEE NACCHO Response

SEE an Indigenous Patients Response

See Nurses PAQ Misleading and false campaign

4. AMSANT  has called for re-doubled efforts to implement the recommendations of the Royal Commission into the care and protection of children in partnership with NT Aboriginal leaders

Read full AMSANT press Release

Listen to interview with Donna Ah Chee

Press Release @NACCHOChair calls on the Federal Government to work with us to keep our children safe

#WeHaveTheSolutions Plus comments from CEO’s @Anyinginyi @DanilaDilba

4.Dialysis facilities worth $17 million are sitting padlocked, empty and unused in WA’s north

Read full Story HERE

6.ALRC Report into Incarceration of Aboriginal and Torres Strait Islander People;

Read Download Full Transcript

Senator Patrick Dodson

Download the report from HERE

Community Groups Call For Action on Indigenous Incarceration Rates

7. Minister Ken Wyatt : Listening to Indigenous Needs: Healthy Ears Program Extended with $29.4 commitment

The Australian Government has committed $29.4 million to extend the Healthy Ears – Better Hearing, Better Listening Program, to help ensure tens of thousands more Indigenous children and young adults grow up with good hearing and the opportunities it brings.

Read Press Release HEAR

8.Tangentyere Alice Springs Women’s Family Safety Group visits Canberra

This week the Tangentyere Women’s Family Safety Group from Alice Springs were in Canberra. They shared with politicians, their own solutions for their own communities, and they are making an enormous difference.
Big thanks to all the Tangentyere women who made it to Canberra.

Read Download the Press Release

TANGENTYERE WOMEN’S FAMILY SAFETY GROUP (FED

9. Minister Ken Wyatt launches our NACCHO RACGP National Guide to a preventative health assessment for Aboriginal and Torres Strait Islander people

Read press releases and link to Download the National Guide

10. Your guide to a  healthy Easter : #Eggs-actly  

And finally hope you had a Happy Easter all you mob ! After you have enjoyed your chocolate eggs and hot cross buns , this is how much exercise you will require to work of those Easter treats .

For medical and nutrition advice please check with your ACCHO Doctor , Health Promotion / Lifestyle teams or one of our ACCHO nutritionists

 

Part B Full Text The Australian Article Easter Monday

There is no reason it should have happened, especially not in a first-world country like Australia, but it has: indigenous communities in the country’s north are in the grip of wholly treatable sexually transmitted diseases.

In the case of syphilis, it is an epidemic — West Australian Labor senator Patrick Dodson ­described it as such, in a fury, when health department bureaucrats mumbled during Senate estimates about having held a few “meetings” on the matter.

There have been about 2000 syphilis notifications — with at least 13 congenital cases, six of them fatal — since the outbreak began in northern Queensland in 2011, before spreading to the Northern Territory, Western Australia and, finally, South Australia.

What’s worse, it could have been stopped. James Ward, of the South Australian Health and Medical Research Institute, wrote in mid-2011 that there had been a “downward trend” over several years and it was likely at that point that the “elimination of syphilis is achievable within indigenous ­remote communities”.

But governments were slow to react, and Ward is now assisting in the design of an $8.8 million emergency “surge” treatment approach on the cusp of being rolled out in Cairns and Darwin, with sites in the two remaining affected states yet to be identified.

It will be an aggressive strategy — under previous guidelines, you had to have been identified during a health check as an active carrier of syphilis to be treated. Now, anyone who registers antibodies for the pathogen during a blood prick test, whether actively carrying syphilis or not, will receive an ­immediate penicillin injection in an attempt to halt the infection’s geographical spread.

This is key: the high mobility of indigenous people in northern and central Australia means pathogens cross jurisdictions with ­impunity. Australian Medical ­Association president Michael Gannon calls syphilis a “clever bacterium that will never go away”, warning that “bugs don’t respect state borders”.

Olga Havnen, one of the Northern Territory’s most respected public health experts, points out that many people “will have connections and relations from the Torres Strait through to the Kimberley and on to Broome — and it’s only a matter of seven or eight kilometres between PNG and the northernmost islands there in the Torres Strait”.

“This is probably something that’s not really understood by the broader Australian community,” Havnen says. “I suspect once you get a major outbreak of something like encephalitis or Dengue fever, any of those mosquito-borne diseases, and that starts to encroach onto the mainland, then people will start to get a bit worried.”

Olga Havnen, CEO of the Danila Dilba Health Service, says transmission is complex issue in Australia’s indigenous communities.
Olga Havnen, CEO of the Danila Dilba Health Service, says transmission is complex issue in Australia’s indigenous communities.

But it is not just syphilis — ­indeed, not even just STIs — that have infectious disease authorities concerned and the network of Aboriginal Community Controlled Health Organisations stretched.

Chlamydia, the nation’s most frequently diagnosed STI in 2016 based on figures from the Kirby Institute at the University of NSW, is three times more likely to be contracted by an indigenous Australian than a non-­indigenous one.

The rate was highest in the NT, at 1689.1 notifications per 100,000 indigenous people, compared with 607.9 per 100,000 non-indigenous Territorians. If you’re indigenous, you’re seven times more likely to contract gonorrhoea, spiking to 15 times more likely if only women are considered. Syphilis, five times more likely.

As the syphilis response gets under way, health services such as the one Havnen leads, the Darwin-based Danila Dilba, will be given extra resources to tackle it. “With proper resourcing, if you want to be doing outreach with those people who might be visitors to town living in the long grass, then we’re probably best placed to be able to do that,” she says.

But the extra focus comes with a warning. A spate of alleged sexual assaults on Aboriginal children, beginning with a two-year-old in Tennant Creek last month and followed by three more alleged ­attacks, has raised speculation of a link between high STI rates and evidence of child sexual assault.

After the first case, former NT children’s commissioner Howard Bath told this newspaper that STI rates were “a better indicator of background levels of abuse than reporting because so many of those cases don’t get reported to anyone, whereas kids with serious infections do tend to go to a ­doctor”. Others, including Alice Springs town councillor Jacinta Price and Aboriginal businessman Warren Mundine, raised the ­spectre of the need for removing more at-risk indigenous children from dangerous environments.

Children play AFL in Yeundumu. Picture: Jason Edwards
Children play AFL in Yeundumu. Picture: Jason Edwards

However, Sarah Giles, Danila Dilba’s clinical director and a medical practitioner of 20 years’ standing in northern Australia, warns this kind of response only exacerbates the problem. She is one of a range of public health authorities who, like Havnen, say connecting high STI figures to the very real scourge of child sex abuse simply makes no sense. They do not carry correlated data sets, the experts say.

“One of the things that’s really unhelpful about trying to manage STIs at a population level is to link it with child abuse and mandatory reporting, and for people to be fearful of STIs,” Giles says. “The problem is that when they’re conflated and when communities feel that they can’t get help ­because things might be misinterpreted or things might be reported, they’re less likely to present with symptoms. The majority of STIs are in adults and they’re sexually transmitted.”

Havnen says there is evidence of STIs being transmitted non-sexually, including to children, such as through poor hand ­hygiene, although Giles says that is “reasonably rare”. And while NT data shows five children under 12 contracted either chlamydia or gonorrhoea in 2016 (none had syphilis), and there were another five under 12 last year, Havnen points to the fact that over the past decade there has been no increasing trend in under 12s being affected. Where there has been a rise in the NT is in people aged between 13 and 19, with annual gonorrhoea notifications increasing from 64 cases in the 14-15-year-old ­female cohort in 2006 to 94 notifications in 2016.

In the 16-17-year-old female ­cohort the same figures were 96 and 141 and in the 12-13-year-old group it rose from 20 in 2006 to 33 in 2016. Overall, for both boys and girls under 16, annual gonorrhoea notifications rose from 109 in 2006 to 186 in 2016, according to figures provided to the royal ­commission into child detention by NT Health. Havnen describes the rise as “concerning but not, on its own, evidence of increasing ­levels of sexual abuse”.

Ward is more direct. Not all STIs are the result of sexual abuse, he warns, and not all sexual abuse results in an STI. If you’re a health professional trying to deal with an epidemiological wildfire, the distinction matters — the data and its correct interpretations can literally be a matter of life and death.

Indeed, in its own written cav­eats to the material it provided to the royal commission, the department warns that sexual health data is “very much subject to variations in testing” and warns against making “misleading assumptions about trends”. Ward says: “Most STIs notified in remote indigenous communities are ­assumed to be the result of sex ­between consenting adults — that is, 16 to 30-year-olds. Of the under 16s, the majority are 14 and 15-year-olds.” He says a historically high background prevalence of STIs in remote indigenous communities — along with a range of other ­infectious diseases long eradicated elsewhere — is to blame for their ongoing presence. Poor education, health services and hygiene contribute, and where drug and ­alcohol problems exist, sexually risky behaviour is more likely too. The lingering impact of colonisation and arrival of diseases then still common in broader ­society cannot be underestimated.

But Ward claims that an apparently high territory police figure of about 700 cases of “suspected child sexual offences” in the NT over the past five years may be misleading. He says a large number of these are likely to be the result of mandatory reporting, where someone under 16 is known to have a partner with an age gap of more than two years, or someone under 14 is known to be engaging in sexual activity. Ward points out that 15 is the nationwide ­median sexual debut age, an age he suggests is dropping. At any rate, he argues, child sex abuse is unlikely to be the main reason for that high rate of mandatory ­reporting in the NT.

Areyonga is a small Aboriginal community a few hours drive from Alice Springs.
Areyonga is a small Aboriginal community a few hours drive from Alice Springs.

Data matters, and so does how it is used. Chipping away at the perception of child sexual abuse in indigenous communities are the latest figures from the Australian Institute of Health and Welfare showing the rate of removals for that crime is actually higher in non-indigenous Australia.

According to a report this month from the AIHW, removals based on substantiated sex abuse cases in 2016-17 were starkly different for each cohort: 8.3 per cent for indigenous children, from a total of 13,749 removals, and 13.4 per cent for non-indigenous children, from 34,915 removals.

Havnen concedes there is a need for better reporting of child abuse and has called for a confidential helpline that would be free of charge and staffed around the clock by health professionals.

It’s based on a model already in use in Europe that she says deals with millions of calls a year — but it would require a comprehensive education and publicity campaign if it were to gain traction in remote Australia. And that means starting with the adults.

“If you’re going to do sex ­education in schools and you start to move into the area about sexual abuse and violence and so on, it’s really important that adults are ­educated first about what to do with that information,” she says. “Because too often if you just ­educate kids, and they come home and make a disclosure, they end up being told they’re liars.”

These challenges exist against the backdrop of a community already beset by a range of infectious diseases barely present elsewhere in the country, including the STIs that should be so easily treatable. It is, as Havnen is the first to admit, a complex matter.

Cheryl Jones, president of the Australasian Society for Infectious Diseases, says the answer is better primary treatment solutions and education, rather than trying to solve the problem after it has ­occurred. “For any of these public health infectious disease problems in ­remote and rural areas, we need to support basic infrastructure at the point of care and work alongside communities to come up with ­solutions,” she says.

Sisters play in the mud after a rare rain at Hoppy's 'town camp' on the outskirts of Alice Springs.
Sisters play in the mud after a rare rain at Hoppy’s ‘town camp’ on the outskirts of Alice Springs.

Pat Turner, chief executive of peak body the National Aboriginal Community Controlled Health Organisation, is adamant about this. “These (STIs) are preventable diseases and we need increased testing, treatment plans and a ­culturally appropriate health ­education campaign that focuses resources on promoting safe-sex messages delivered to at-risk ­communities by our trained Aboriginal workforce,” Turner says.

The Australian Medical ­Association has called for the formation of a national Centre for Disease Control, focusing on global surveillance and most likely based in the north, as being “urgently needed to provide national leadership and to co-ordinate rapid and effective public health responses to manage communicable diseases and outbreaks”.

“The current approach to disease threats, and control of infectious diseases, relies on disjointed state and commonwealth formal structures, informal networks, collaborations, and the goodwill of public health and infectious disease physicians,” the association warned in a submission to the Turnbull government last year.

However, the federal health ­department has rebuffed the CDC argument, telling the association that “our current arrangements are effective” and warning the suggestion could introduce “considerable overlap and duplication with existing functions”.

“I think it (the CDC) might have some merit, if it helps to ­advocate with government about what needs to happen,” Havnen says, “but if these things are going to be targeted at Aboriginal bodies, it needs to be a genuine partnership. It’s got to be informed by the realities on the ground and what we know. That information has to be fed up into the planning process.”

NACCHO Aboriginal #EarHealthforLife @KenWyattMP and @AMAPresident Launch AMA Indigenous Health Report Card 2017:

 

 

” The Aboriginal and Torres Strait Islander population is reported to suffer the highest rates of otitis media in the world.  This unacceptably high prevalance has been known for at least 60 years.

The 2017 Report Card on Indigenous Health identifies chronic otitis media as a ‘missing piece of the puzzel for Indigenous disadvantage’ and calls for an end to the preventable scourge on the health of Indigenous Australians.”

Download AMA Indigenous Health Report Card 2017: A National Strategic Approach to Ending Chronic Otitis Media and its Life Long Impacts in Indigenous Communities

2017 Report Card on Indigenous Health

“ This is a disease of poor people in poor countries as well as other indigenous minorities. These unacceptably high rates have been known for at least 60 years,

Chronic otitis media has lifelong impacts for health and wellbeing just like cardiovascular disease or diabetes – its effects are often ‘life sentences’ of disability and are linked to high rates of Indigenous incarceration.”

National Aboriginal Community Controlled Health Organisation (NACCHO) Chair, Mr. John Singer said Indigenous children experience some of the highest rates of chronic otitis media in the world.

Download NACCHO Press Release

NACCHO Press Release response AMA release Indigenous Report card.doc

NACCHO welcomes the 2017 AMA Report Card on Indigenous Health: A national strategic approach to ending chronic otitis media See Part 2 below

  ” Report Cards can be daunting, they can be challenging, and they can be inspiring – but above all, they are valuable.

They help provide foundations for informed decision making – something I thoroughly endorse.

And in the case of Indigenous health, they highlight issues that many of the more than 27,000 registered doctors, students and advocates who the AMA represents, deal with every day.

So I commend the AMA on its 2017 Report Card on Indigenous Health – the latest in a series of highly authoritative and respected reports on the crucial issue of Aboriginal Aboriginal and Torres Strait Islander health.’

The Hon Ken Wyatt launch speech see in full Part 5

Part 1 AMA Background

Otis media is a build up of fluid in the middle ear cavity, which can become infected.  While the condition lasts, mild or moderate hearing loss is experienced.

Otitis media is very common in children and for most non-Indigenous children, is readily treated. But for many Indigenous people, otitis media is not adequately treated.  It persists in chronic forms over months and years.

As this Report Card identifies, the peak prevalence for otitis media in some Indigenous communities is age five months to nine months; with up to one-third of six-month-old infants suffering significant hearing loss.  The effects of long periods of mild or moderate hearing loss at critical developmental stages can be profound.  During the first 12 or so months of life, a person’s brain starts to learn to make sense of the sounds it is hearing.  This is called ‘auditory processing’.  If hearing is lost during this critical period, and even if normal hearing returns later, life-long disabling auditory processing disorders can remain.

Chronic otitis media is a disease in communities with poorer social determinants of health.  It is a disease of the developing world.  It should not be an endemic ‘massive health problem’ in Australia – one of the healthiest and wealthiest countries in the world.  However the chronic otitis media crisis is occurring in too many of our Indigenous communities.

This Report Card calls for a national, systematic approach to closing the gap in the rates of chronic otitis media between Indigenous and non-Indigenous infants and children in Australia, and a response to the lasting, disabling effects and social impacts of chronic otitis media in the Indigenous adult population.

Part 2 NACCHO welcomes the 2017 AMA Report Card on Indigenous Health: A national strategic approach to ending chronic otitis media 

The peak body for Aboriginal controlled medical services today welcomed the release of the AMA’s 2017 Report Card on Indigenous Health and joined its call for a national, systematic approach to closing the gap in the rates of chronic otitis media between Indigenous and non-Indigenous children in Australia. This disease has long term disabling effects and social impacts in the Indigenous adult population.

National Aboriginal Community Controlled Health Organisation (NACCHO) Chair, Mr. John Singer said Indigenous children experience some of the highest rates of chronic otitis media in the world.

“This is a disease of poor people in poor countries as well as other indigenous minorities. These unacceptably high rates have been known for at least 60 years,” Mr. Singer said.

Chronic otitis media has lifelong impacts for health and wellbeing just like cardiovascular disease or diabetes – its effects are often ‘life sentences’ of disability and are linked to high rates of Indigenous incarceration.

NACCHO calls on Australian governments to adopt the recommendations of the Report including embedding chronic otitis media and hearing loss in the Closing the Gap Strategy. However in addition to these principles specialist ear disease and hearing services must be provided to all Aboriginal children if this disease is to be tackled.

Like many chronic diseases impacting on the gap in life expectancy, otitis media is linked to poorer social determinants. “If we are serious about improving health outcomes for Indigenous people, governments at all levels must do more to improve education, housing and employment outcomes.” Mr. Singer said.

Indigenous led solutions must be at the center of any approach. Aboriginal people are more likely to access the care and support they need from an Aboriginal controlled organisation. The community controlled sector has the experience, history and expertise in working with Aboriginal communities and are best placed to work with governments on the report recommendations. Our members should be the preferred model for investment in comprehensive primary health care services.

Our members across the country are keen to work with governments on a systematic approach to the prevention, detection, treatment and management of otitis media,” Mr. Singer said.

NACCHO, its Affiliates and members will continue to work with the AMA in the hope that the report will be a catalyst for coordinated, sustainable government action to improve ear health among Aboriginal and Torres Strait Islander people.

Part 3 INDIGENOUS EAR HEALTH – AMA CALLS FOR ACTION TO END A ‘LIFE SENTENCE’ OF HARM

AMA Indigenous Health Report Card 2017: A National Strategic Approach to Ending Chronic Otitis Media and its Life Long Impacts in Indigenous Communities

The AMA today issued a challenge to all Australian governments to work with health experts and Indigenous communities to put an end to the scourge of poor ear health – led by chronic otitis media – affecting Aboriginal and Torres Strait Islander Australians.

At the launch of the 2017 AMA Indigenous Health Report Card in Canberra today, AMA President, Dr Michael Gannon, said the focus on ear health was part of the AMA’s step by step strategy to create awareness in the community and among political leaders of the unique and tragic health problems that have been eradicated in many parts of the world, but which still afflict Indigenous Australians.

The Report Card – A National Strategic Approach to Ending Chronic Otitis Media and its Life Long Impacts in Indigenous Communities – was launched by the Minister for Indigenous Health, The Hon Ken Wyatt AM.

“It is a tragedy that, in 21st century Australia, poor ear health, especially chronic otitis media, is still condemning Indigenous people to a life sentence of hearing problems – even deafness,” Dr Gannon said.

“Chronic otitis media is a disease of poverty, linked to poorer social determinants of health including unhygienic, overcrowded conditions, and an absence of health services.

“It should not be occurring here in Australia, one of the world’s richest nations. It is preventable.

“Otitis media is caused when fluid builds up in the middle ear cavity and becomes infected.

“While the condition lasts, mild or moderate hearing loss is experienced. If left untreated, it can lead to permanent hearing loss.”

Dr Gannon said that, for most non-Indigenous Australian children, otitis media is readily treated.

“The condition in the non-Indigenous population passes within weeks, and without long-term effects.

“But for many Aboriginal and Torres Strait Islander children, otitis media is not adequately treated. It persists in chronic forms over months and years. At worst, it is there for life.”

Estimates show that an average Indigenous child will endure middle ear infections and associated hearing loss for at least 32 months, from age two to 20 years, compared with just three months for a non-Indigenous child.

Dr Gannon said the AMA wants a national, systematic approach to closing the gap in the rates of chronic otitis media between Indigenous and non-Indigenous infants and children in Australia.

“We urgently need a coordinated national response to the lasting, disabling effects and social impacts of chronic otitis media in the Indigenous adult population,” Dr Gannon said.

“We urge our political leaders at all levels of government to take note of this Report Card and be motivated to act to implement solutions.”

The AMA calls on Australian governments to act on three core recommendations:

Recommendation 1:

That a coordinated national strategic response to chronic otitis media be developed by a National Indigenous Hearing Health Taskforce under Indigenous leadership for the Council of Australian Governments (COAG). This should build on and incorporate existing national and State and Territory level responses and include:

  •  a critical analysis of current approaches, and to identify the range of reasons that current chronic otitis media crisis persists;
  •  the development of a COAG Closing the Gap target about new cases of chronic otitis media and hearing loss in Indigenous infants and children under 12 years of age;
  •  a national otitis media surveillance program to monitor prevalence and support a targeted and cost-effective national response;
  •  a significantly increased focus on prevention – both primordial prevention with a focus on the social determinants of the disease, and primary prevention including family and community health literacy about otitis media;
  •  a central, adequately funded and supported role for primary health care and Aboriginal Community Controlled Health Services (ACCHS) in a systematic approach to the prevention, detection, treatment, and management of otitis media; and
  •  access to ear, nose and throat (ENT) specialists, particularly within ACCHS and other Indigenous-specific primary health care services, based on need

Recommendation 2:

That the national approach proposed in Recommendation 1 include addressing the wider impacts of otitis media-related developmental impacts and hearing loss, including on a range of areas of Indigenous disadvantage such as through the funding of research as required. This includes:

  •  a national approach to supporting Indigenous students with hearing loss that aims to remove disadvantage that they may face in educational settings;
  •  a national approach to developing hearing loss-responsive communication strategies in all government and non-government agencies providing services to Indigenous people including – but not limited to – health, mental health, justice, and employment services; and
  •  exploring the support role of the National Disability Insurance Scheme (NDIS) to Indigenous people with hearing loss

Recommendation 3:

That attention of governments be re-directed to the recommendations of the AMA’s 2015 Indigenous Health Report Card, which called for an integrated approach to reducing Indigenous imprisonment rates by addressing underlying causal health issues (including otitis media and related hearing loss and developmental impacts), with the expectation of appropriate action. The health issues to be addressed include mental health problems, cognitive disabilities, alcohol and drug problems, hearing loss, and developmental impacts associated with otitis media. 3

Part 4 : Background

  •  Indigenous children experience some of the highest rates of chronic suppuratives otitis media (CSOM) in the world.
  •  Chronic otitis media in infancy and childhood can affect Indigenous peoples’ adult health and wellbeing as much as cardiovascular disease or diabetes, and its effects are significant ‘life sentences’ of disability.
  •  Chronic otitis media has life-long impacts that bring greater risk of a range of adult social problems, not the least of which is incarceration. The association of chronic otitis media-related hearing loss and the high rates of Indigenous imprisonment has been noted for over 25 years now – but with little action evident

The AMA Indigenous Health Report Card 2017 – A National Strategic Approach to Ending Chronic Otitis Media and its Life Long Impacts in Indigenous Communities – is at https://ama.com.au/article/2017-ama-report-card-indigenous-health-national-strategic-approach-ending-chronic-otitis

Part 5 Ken Wyatt Speech

I’d like to acknowledge the traditional custodians of the land on which we meet – the Ngunnawal and Ngambri people – and pay my respects to their Elders, past and present.

I thank AMA President Dr Michael Gannon and Associate Professor Kelvin Kong of the Royal Australasian College of Surgeons for their words, and acknowledge:

  • AMA Secretary-General Anne Trimmer
  • Representatives from the College,
  • the AMA’s Indigenous Health Taskforce,
  •  the National Aboriginal Community Controlled Health Organisation (NACCHO), and Aboriginal medical centre

My Parliamentary colleagues, and distinguished guests.

Report Cards can be daunting, they can be challenging, and they can be inspiring – but above all, they are valuable.

They help provide foundations for informed decision making – something I thoroughly endorse.

And in the case of Indigenous health, they highlight issues that many of the more than 27,000 registered doctors, students and advocates who the AMA represents, deal with every day.

So I commend the AMA on its 2017 Report Card on Indigenous Health – the latest in a series of highly authoritative and respected reports on the crucial issue of Aboriginal Aboriginal and Torres Strait Islander health.

Over the past 15 years, this annual Report Card has highlighted priority issues such as low birth weight babies, institutionalised inequities and racism, government funding, medical workforce, rheumatic heart disease, and best practice in primary care.

I welcome this year’s Report Card, with its focus on ear health and hearing loss, which can have devastating impacts.

Compounding this is the fact that the most common ear afflictions are almost entirely preventable.

For all the wrong reasons, ear disease is highly prevalent in Indigenous children and repeated episodes can lead to hearing loss and deafness, if not treated early.

The impact of this can have lifelong effects on education, employment and wellbeing.

Nowhere have these consequences been more evident than in my home State of Western Australia, where significant numbers of hearing-impaired Aboriginal people have been unable to secure mining boom jobs, despite their best efforts and support from major companies.

While I agree with Dr Gannon that this Report Card can be ‘a catalyst for government action to improve ear health among Aboriginal and Torres Strait Islander people’, I would like to point out that the Turnbull Government has much work under way aimed at improving Indigenous ear health.

We are resolutely committed to turning this problem around.

The AMA’s Report Card calls for a national, systematic and strategic approach to address chronic otitis media and its impacts in Indigenous communities, and for this approach to be reflected in the Council of Australian Governments Closing the Gap targets.

I note the AMA recommends that any such national response be developed for COAG by a National Indigenous Hearing Health Taskforce, importantly under Indigenous leadership, and that it should build on and incorporate existing national, State and Territory-level responses.

In March, the COAG Health Council agreed to explore the feasibility of such a national approach to reducing the burden of middle ear disease.

The Queensland Department of Health has leadership of this proposal, and plans to take it to the Australian Health Ministers’ Advisory Council next week, when it is scheduled to consider the matter on 8 December.

Alongside this, the House of Representatives Standing Committee on Health, Aged Care and Sport Inquiry into Hearing Health and Wellbeing of Australia is calling for a national strategy to be developed and additional funding provided.

The recommendations of the committee’s report – titled ‘Still waiting to be heard’ – are currently being given detailed consideration by the Turnbull Government, as are the findings of the Department of Health’s independent examination of Commonwealth ear health initiatives.

The AHMAC work and the ‘Still waiting to be heard’ report will inform the way forward on Indigenous ear health.

It’s also pertinent to note a number of other initiatives that will contribute directly to improved ear health.

The Turnbull Government has committed to incorporating a social determinants and cultural determinants of health approach in the next iteration of the five-year Implementation Plan for the National Aboriginal and Torres Strait Islander Health Plan, due to be released in 2018.

As Dr Gannon has pointed out, ‘social determinants of health contribute to the development of ear disease …. and act as barriers to treatment and prevention.’

The release of the Cultural Respect Framework 2016–2026, which was endorsed by AHMAC early this year, will underpin the delivery of culturally competent health service delivery.

A culturally competent approach by health professionals is critical to the health and wellbeing of Aboriginal and Torres Strait Islander people who, like all Australians, have the right to safe, culturally comfortable care of the highest clinical standard.

Further, COAG is currently working to refresh the Closing the Gap targets, including the health targets.

Initiatives like these demonstrate the commitment of good minds and good people to tackling our nation’s most confronting health issue – Indigenous health.

That commitment is also reflected in Commonwealth funding. To improve ear health, a total of $76.4 million, from 2012–13 to 2021–22, is being provided through the Indigenous Australians’ Health Programme, and the National Partnership on Northern Territory Remote Aboriginal Investment.

This funding is increasing access to clinical services, including surgery. It is providing equipment, training health professionals and raising awareness of otitis media symptoms and the need for early treatment.

In the past year, this has resulted in around 47,000 patient contacts in more than 300 locations across Australia.

More than 200 surgeries were provided, and over 1000 health professionals received training in 80 locations.

More than 1000 pieces of diagnostic equipment were available across 170 sites; and clinical guidelines were made available nationally.

As well, under the Australian Hearing Specialist Program for Indigenous Australians, the Australian Government provides hearing services in more than 200 Aboriginal and Torres Strait Islander communities across Australia each year to help overcome distance, culture and language barriers.

Successful initiatives, such as Children’s Health Queensland’s Deadly Ears program, are making a difference. Deadly Ears has helped almost halve the rate of Chronic Otitis Media, working at 11 outreach services in rural and remote areas.

So, clearly, there is a large body of work underway at local, State and national levels – but just as clearly, we must continue our focus, build our partnerships and broaden our approach.

While primary care is fundamental to ear health solutions, we must work together with Aboriginal communities to advance other areas of life which impact on health and wellbeing.

The Turnbull Government understands this, and this is the basis for our whole-of-government policies, including housing, education, employment and health service delivery.

We are focussed on what works, so efficient and successful models of care can be shared and replicated.

We are concentrating on grassroots empowerment, to support local responsibility, and in turn, to grow personal commitment.

Finding ear health solutions is a shared responsibility – for all governments, the medical profession, health workers, and parents and their children.

Reducing ear problems is one of my top Indigenous health priorities, and I’m confident we can start to make real gains in this critical area.

While there is undoubtedly a way to go, evidence-based Report Cards like this will help ensure we are on the right track.

The Turnbull Government is listening.

I commend the AMA for its work, and look forward to continuing our shared dedication to better hearing for Indigenous people.

Thank you.

 

 

NACCHO Aboriginal Hearing Health : 94 per cent of Indigenous inmates in the NT have significant hearing loss

 

” Eighty four per cent of adults and 96 per cent of juveniles detained in the Northern Territory are Indigenous, though they only make up 25 per cent of the population.

In my research I found that hearing-impaired Aboriginal people are more likely to be arrested and charged with crimes because they cannot explain themselves to police or give adequate instructions to their solicitor, are less likely to be viewed as a credible witnesses in court, and tend to have misunderstandings with corrections staff.”

Psychologist Dr Damien Howard ( see his PowerPoint presentation below ) 

 

 ” Ministers agreed that the ear and hearing health of Aboriginal and Torres Strait Islander children is an important issue that impacts on their health, education, and employment outcomes.

Accordingly, Ministers agreed to explore the feasibility of a national approach to reducing the burden of middle ear disease and associated hearing loss on Aboriginal and Torres Strait Islander people. This is an important step towards achieving Closing the Gap targets. “

COAG Health Council Communique  24 March 2017

Read over 30 previous NACCHO articles Ears and Hearing

When Aboriginal prisoners appear before a magistrate waiting to be sentenced in Darwin, a guard is usually sitting in the dock right beside them. Troy Vanderpoll used to be one of those prison officers.

Article originally published

The Aboriginal inmate is asked a few questions. He nods in agreement with the magistrate, repeating, “yes”, over and over again.

The session finishes, the inmate stands, and the court moves on to the next case.

The man turns to the guard: “How much did I get?”

Mr Vanderpoll is Indigenous himself, and used to work as the Aboriginal Liaison Officer in Northern Territory prisons.

He spent a lot of time with Aboriginal inmates, and noticed that some of the men seemed withdrawn, and did their best to avoid interacting with guards, parole officers and judges — even when it was in their best interests.

Hidden epidemic

In 2010, Mr Vanderpoll spoke to a local psychologist, Damien Howard, who had a theory on why that was — a hidden epidemic of hearing loss.

Damien had studied the impact of hearing loss on Indigenous people for more than two decades, but had never seen research published on hearing levels of adult prisoners in the Northern Territory.

Before Mr Vanderpoll became a prison guard, he was a medic in the Australian Army, where he learned how to conduct hearing testing. In the defence forces, biannual checks are mandatory.

In response to Mr Vanderpoll and Dr Howard’s interest, Robert Miller — then acting superintendent of Darwin Correctional Centre and Mr Vanderpoll’s stepfather — commissioned the pair to conduct hearing testing for Aboriginal inmates.

Mr Vanderpoll tested the hearing of volunteers at correctional centres in Darwin and Alice Springs, and Dr Howard helped compile the results.

The findings made news headlines: 94 per cent of the inmates tested had significant hearing loss.

The result reflected a wider public health issue: in remote communities, up to 45 per cent of Aboriginal people have hearing loss, often due to preventable childhood ear diseases.

Presentation  : Health practitioners improving communication with Indigenous patients and family members with hearing loss.

Mr Miller had by then worked in Corrections for over 25 years. The result was a revelation.

“I think it shocked all of us that the hearing loss was so great,” he says.

“The doors open and the memory goes back: some prisoners seemed to be not talking to you, ignoring what you’re saying. You understand now that he’s got a hearing problem, no wonder he couldn’t hear what I was saying.

“If you don’t know about it then you may just think that the prisoner is being ignorant or rude in not responding to something that you’ve said.”

Then there were the inmates who Mr Vanderpoll realised must have been deaf in one ear.

“Sometimes you’re talking to someone and they completely ignore you because they’re facing the wrong way,” he says.

 

Photo: 94 per cent of Indigenous inmates in the Northern Territory have significant hearing loss. (ABC RN: Jake Duczynski)

Aboriginal men in NT prisons regularly use hand gestures — but Mr Vanderpoll and Dr Howard say that was no clear indication of hearing loss. Aboriginal spoken languages in the Northern Territory include signing, and many inmates speak English as a second or third language.

“The boys are always signing. Always, whether they can hear or not, they’re still signing,” Mr Miller says.

If Mr Vanderpoll and Dr Howard were shocked by the results, so too were the inmates. Most prisoners had no idea they had hearing problems before the study.

“They’d grown up with it. That had been their whole life,” Mr Vanderpoll says.

But whether they know they have it or not, hearing loss impacted their experiences in the justice system.

Mr Vanderpoll began having conversations with prisoners who admitted avoiding interacting with the parole board because of their hearing loss, giving up a chance for a reduced sentence.

“Anything that put them in a position where they had to talk to a stranger or be reviewed by a stranger was so shocking or so scary to them, that they’d rather stay in prison and complete their full time without any chance of parole,” he says.

“If you’ve got hearing issues, you don’t want to be put into that position.”

Interpreter shortage

While most hearing impaired and deaf Aboriginal inmates Mr Vanderpoll worked with didn’t ask for an interpreter in legal situations, the service might not have been available for them anyway.

There is only one professionally-qualified Auslan interpreter available for inmates across the entire Northern Territory, meaning that many deaf people miss out.

The interpreter, Liz Temple, readily admits that she does not have fluency in the local Aboriginal sign languages that most prisoners with hearing loss use.

She often relies on Aboriginal consultants, such as Jody Barney, a deaf Indigenous woman who often works in the region and has knowledge of multiple Aboriginal sign languages. However, funding for such services is limited.

Instead, corrections officers often play quasi-interpreters for inmates, says Mr Vanderpoll.

“You’d listen to the magistrate and you’d just lean over to the prisoner and just tell him what’s happening as it’s happening in real time. I think the reason that works is because they’re more comfortable.”

Their findings led Robert Miller to wonder whether hearing loss plays a role not only in Aboriginal people’s experience of prison, but also contributes to them ending up there in the first place.

“You can understand why Indigenous incarceration is so high. I’m not saying it’s the only reason, but I think it had quite an impact,” he says.

Eighty four per cent of adults and 96 per cent of juveniles detained in the Northern Territory are Indigenous, though they only make up 25 per cent of the population.

In his research, Howard found that hearing-impaired Aboriginal people are more likely to be arrested and charged with crimes because they cannot explain themselves to police or give adequate instructions to their solicitor, are less likely to be viewed as a credible witnesses in court, and tend to have misunderstandings with corrections staff.

Signs of change

Once the report was released, Mr Vanderpoll and Dr Howard were hopeful things would begin to change.

Mr Miller cobbled together funding for eight hearing aids, as he recalls — at a cost of less than $2,000.

“It wasn’t huge, but when you’re spending government money it’s got to be justified,” he says.

He had hoped that the small pilot program would eventually be funded by the government.

“There was no money in the Darwin Correctional Centre budget for hearing assistance,” he says.

Before the Darwin trial, in his eight years in NT prisons, Mr Vanderpoll says he saw only two people wearing hearing aids.

He recalls watching inmates putting on the new devices, realising what they had been missing.

“They could understand what they were supposed to be hearing in the first place,” he says.

Mr Vanderpoll hoped to implement a comprehensive training program for guards, who he says often had good relationships with inmates.

“I don’t think you can highlight that enough, that when they’re in prison, the officers aren’t their enemies.”

Still, there were correctional officers who got it, and those who didn’t, the ones who are “coming in yelling and screaming”.

The officers with the best rapport with the prisoners, Mr Vanderpoll observed, were those who made an effort to communicate.

“There’s a lot of knowledge. Some have 30 years of dealing with Indigenous inmates and they have developed a really good set of listening skills and speaking skills. We were trying to map that out so we could disseminate that in some form of training.”

Hope and disappointment

Their 2011 report made a number of recommendations that they believed could improve the way the justice system caters for hearing-impaired Aboriginal people — including routine testing of new inmates’ hearing, better access to hearing aids, and improved training for police, the judiciary and correctional staff.

Mr Vanderpoll’s biggest hope was to see records of inmates’ hearing levels shared between police and the courts.

“So that when [police] deal with someone, they bring that person up and say, ‘All right, he’s deaf in the left ear,’ and they can be aware of that when they’re dealing with them,” he says.

Mr Vanderpoll left the NT Department of Correctional Services in 2013, and now works for the state’s Department of Trade, Business and Innovation, while Mr Miller has retired.

To Dr Howard’s knowledge, none of the 2011 report’s recommendations have been implemented.

The NT Department of Corrections never contacted him about the report.

The Department of the Attorney General and Justice said that as part of an initial training program, correctional officers learned to deal with prisoners with impairments, including hearing loss.

Mr Vanderpoll’s idea of record sharing went nowhere. “That’s the most disappointing part,” he says.

Hearing loss remains ‘the smoking gun’

In the aftermath of the abuse of Aboriginal teenagers by guards at Don Dale Youth Detention Centre in 2016, Dr Howard told the royal commission that hearing loss amongst Aboriginal adults and young people continues to be the “smoking gun” contributing to very high rates of detention — and communication problems with police and guards.

“With rare exceptions, governments and corrections agencies in all jurisdictions, as well as the criminal justice research organisations, have displayed a perplexing disinterest in this important issue,” Dr Howard says.

“A common response of government and Corrections is to classify Aboriginal hearing loss only as a “health problem”.

When asked if audiological testing was now conducted for adult prisoners entering the correctional system, the NT Department of the Attorney General and Justice referred the ABC to the Department of Health.

The Department of Health says adult prisoners are asked if they have hearing issues when they enter prison. Yet as Mr Vanderpoll and Dr Howard’s research found, many inmates are unaware of their hearing loss.

The NT Department of Corrections provides prisoners with a hearing aid if they have a referral from a medical practitioner.

Juvenile detainees in Darwin and Alice Springs are now given a hearing screening test undertaken by a nurse. The service began this year.

Mr Miller says people in the Department of Corrections “try really hard” to deliver services under increasingly strained resources.

“The government’s on you every year to be tight … people are not interested in prisoners at all,” Mr Vanderpoll says.

“I think that a lot of the problems that we face today, like Don Dale, was because the money’s been stripped from Corrections, over and over again, and people don’t want to hear about it.

“The prison is always run well because of communication. When it doesn’t run well, when there’s riots and stuff like that, it’s because of a lack of communication.

“You can have all of the foundation skills-type training in the world. You can have mathematics, English, et cetera. You can send people to alcohol rehabilitation courses.

“You can do all these things with people, but if they can’t even hear what you’re saying, how is it going to make a difference?”

Ear trouble training for teachers

NACCHO Aboriginal Health : Download 2 @AIHW Reports : Remote Aboriginal Investment #Oralhealth #EarandHearing

 ” This AIHW report presents information on ear and hearing health outreach services for Aboriginal and Torres Strait Islander children and young people in the Northern Territory. The Australian Government funded these programs and the Northern Territory Government delivered them.

Download the Report HERE : Ear and Hearing Program

AIHW Page and summary in Section 1 Below

” This is the second report on oral health services funded by the Stronger Futures in the Northern Territory Oral Health Program and the Northern Territory Remote Aboriginal Investment Oral Health Program (NTRAI OHP). It covers the period from July 2012 to December 2015.

Where available, data from August 2007 to June 2012 have been included to allow examination of the effect of oral health services over the life course of associated programs delivered in the Northern Territory.”

Download the Report HERE : NT Remote Aboriginal Investment Oral Health Program

AIHW Page and summary in Section 2 Below

Section 1 : Ear and Hearing Service delivery

  • In 2015-16, 2,253 outreach audiology services were provided to 1,981 children and young people; and 1,011 ear, nose and throat (ENT) teleotology services were provided to 936 children and young people.
  • Clinical Nurse Specialists (CNSs) conducted 1,211 visits to 1,125 children in 2015-16. This was an increase from 2014-15 when 668 CNS visits were provided to 622 children.
  • From July 2012 to June 2016, 9,221 outreach audiology services were provided to 5,357 children and young people, 3,799 ENT teleotology services were provided to 2,434 children and young people, and CNS conducted 3,087 visits to 2,614 children.

Improvement in hearing health status

  • The levels of hearing loss and impairment have improved slightly over the last 4 years. In 2015-16, 49% of Indigenous children had some type of hearing loss (compared with 52% in 2012-13) and 32% had a hearing impairment (compared with 37% in 2012-13).
  • Between July 2012 and June 2016, hearing improved for a large proportion of children and young people who received 2 or more audiology services. Almost half (48%) of the children who had hearing loss at their first service showed improvement in hearing at their last service.
  • More than half (59%) of children and young people had a reduction in the degree of their hearing impairment between July 2012 and June 2016.

Improvement in hearing health and ear conditions

  • From July 2012 to June 2016, the proportion of children and young people with at least one middle ear condition decreased from 82% to 75% between their first and last service.
  • Greater decreases were observed over the longer term. From August 2007 to June 2016, the proportion diagnosed with any ear condition decreased from 78% to 49% between their first and last service.

High demand on hearing and ear health services

A large number of hearing and ear health services have been provided, but there is much work yet to do. As at 30 June 2016, 3,090 children and young people were waiting for audiology services, and 1,841 for ENT teleotology services. While ensuring children most in need received services (through the priority listing system), a number of changes have been made to improve the overall efficiency of hearing health services, including enhancing CNS services, health promotion and education activities. However, the high demand on hearing and ear health services continues to be driven by the high prevalence of middle ear conditions among children and the chronic nature of the disease, which means the majority of children require repeated and long-term follow-up services.

Section 2 Oral Health Preventive services

Fluoride varnish treatment

  • In 2014 and 2015, 4,664 and 4,041 Indigenous children and adolescents received 5,054 and 4,441 full-mouth fluoride varnish (FV) applications, respectively. Compared with the previous report period (July 2012 to December 2013), the number of Indigenous children and adolescents who received full-mouth FV applications generally increased.
  • From July 2012 to December 2015, a total of 10,052 Indigenous children and adolescents received 13,541 full-mouth FV applications.

Fissure sealant treatment

  • In 2014 and 2015, 2,179 and 1,804 Indigenous children and adolescents received 2,323 and 1,943 fissure sealant applications, respectively. Compared with the previous report period (January to December 2013), the number of Indigenous children and adolescents who received fissure sealant applications generally increased.
  • From July 2012 to December 2015, a total of 5,324 Indigenous children and adolescents received 6,477 fissure sealant applications.

Clinical services (for example, fillings for tooth decay, and tooth extractions)

  • In 2014 and 2015, 3,159 and 3,378 occasions of clinical service were provided to 2,407 and 2,533 Indigenous children and adolescents, respectively. The number of Indigenous
  • children and adolescents who received clinical services decreased from 2013 to 2014, but increased from 2014 to 2015.
  • From July 2012 to December 2015, a total of 7,660 Indigenous children and adolescents were provided with 12,739 occasions of clinical service.

Oral health status of service recipients

  • In 2014 and 2015, the average number of decayed, missing and filled deciduous (baby) teeth was highest among service recipients aged 6—at 5.4 and 5.6, respectively; the average number for permanent teeth was highest among those aged 15—at 4.1 and 3.7.

Changes over time

  • The proportion of service recipients with experience of tooth decay decreased for most age groups between 2009 and 2015. The greatest decreases was found in the following age groups: for those aged 1–3, from 73% to 42%; for 5-year-olds, from 88% to 79%; and for 12-year-olds, from 81% to 69%.
  • Among children and adolescents who received at least 2 services within each program, those receiving services during the NTRAI OHP had a smaller increase in tooth decay, on average, than those in the Child Health Check Initiative Closing the Gap Program.

NACCHO Aboriginal #Ear Health : #ClosingtheGapDay and hearing loss: an invisible barrier obstructs progress

 

“Avoidance is a way of coping with anxiety about being shamed. Repeated avoidance results in limited engagement and poor outcomes for programs designed to Close the Gap.

The use of hearing loss responsive communication strategies can help to deal with this barrier

 These strategies can be as important as culturally appropriate processes in programs.

Indeed, there is an overlap between the two. For those with hearing loss, what is said in culturally familiar language within a culturally familiar process is easier to understand.”

Hearing loss among Indigenous Australians is a largely unseen barrier to Closing the Gap programs, according to Dr Damien Howard and Jody Barney, who explain how to be “hearing loss responsive” in service delivery and communications.

Originally published

 ” Indigenous Australians have one of the highest levels of ear disease and hearing loss in the world.

Rates are up to ten times more than non-Indigenous Australians and the National Aboriginal Community Controlled Health Organisation estimates Indigenous healthcare is currently 30 to 50 years behind the rest of the country “

Read or Share all NACCHO Ear and Hearing Articles HERE

This weeks NACCHO Aboriginal Health News Alerts will  include

Tuesday Save a date Wednesday Job alerts Thursday NACCHO Members Good News

How to submit ? Email to Colin Cowell NACCHO Media   4.30 pm  day before publication

Communication difficulties caused by the widespread unidentified hearing loss among Indigenous people in Australia continue to undermine the effectiveness of Closing the Gap programs.

An Aboriginal worker with mild hearing loss once commented: “You see that look, the look that tells you they are thinking you are some stupid blackfella and you don’t want to say you don’t understand; ‘Can you tell me it again?’

“You just want to get away and never want to work with them again if you can help it.”

Many people act on these kinds of feelings. They seek to avoid people, situations and service providers because of these reactions. The everyday communication difficulties caused by their hearing loss contribute to anxiety and disengagement. They will often seek to avoid education, health and employment support services designed to help them.

For instance, people may not go to health clinics, or do not comply with provided treatment. Avoidance of specialist medical appointments is one feature of this. In some specialist medical visits to remote communities, 50% of patients do not attend booked appointments. This can have dire health implications for individuals. It is also an immense waste of resources.

When hearing loss begins early in life, it has greater impact than the late onset hearing loss that is experienced by non-Indigenous Australians who are hard of hearing. Their hearing loss is generally caused by occupational noise exposure and ageing.

Indigenous hearing loss is usually caused by endemic childhood middle ear disease. Children with current ear disease often have a temporary hearing loss. Repeated infections can cause lasting damage and some level of permanent mild to moderate hearing loss. Up to 70% of Indigenous people are affected — fewer in urban communities, more in remote communities.

The impact of this hearing loss is pervasive.

We know that school attendance rates for Indigenous children with hearing loss are below those for other students. We know they experience more difficulty with learning when they do attend school. We know they display more behavioural problems when at school. We know Indigenous workers with hearing loss have difficulty securing and holding jobs, have greater performance difficulties and frequently avoid participation in workplace training.

There is also increasing concern about hearing loss as a factor in the over-representation of Indigenous people in the criminal justice system; 94% of prison inmates in the Northern Territory have been found to have a significant degree of hearing loss.

Those familiar with Indigenous disadvantage may wonder why they have not heard about the incidence and impact of hearing loss among adults. One reason is that early onset conductive hearing loss is mostly invisible.

First, most Indigenous people who are hard of hearing are not aware that their hearing is not normal. The early origin of their hearing loss means it is something they have experienced for most of their life. For them, what they how they hear is ‘normal’. If asked, they would deny having a hearing loss.

Second, service providers (teachers, nurses, doctors, trainers, health professionals, social workers and police among them) are unlikely to recognise poor hearing as an issue for people they work with. Communication difficulties arising from hearing loss are generally attributed only to language and cultural differences, or to limited intelligence or poor motivation. The latter two perceptions, when noticed by clients astute in reading body language, can further compound disengagement.

It is easy to imagine that hearing aids are all that is needed to resolve issues. They can help some, but will not resolve all communication difficulties.

The communication issues experienced by an adult with early onset hearing loss are the result of both current hearing loss and the ‘legacy effects’ of unidentified hearing loss since childhood. These may include a preference for visual communication strategies, anxiety related to an intense fear of being ‘shamed’ and a limited store of contextual knowledge that helps with understanding what is said.

A store of contextual knowledge is what people normally acquire through fully hearing what is said to them, and around them. Without a store of relevant contextual knowledge — the big picture — what is said in any situation is harder to understand. So people with early onset hearing loss not only have trouble hearing what is said, but they also frequently have difficulty understanding what they hear.

Avoidance is a way of coping with anxiety about being shamed. Repeated avoidance results in limited engagement and poor outcomes for programs designed to Close the Gap.

The use of hearing loss responsive communication strategies can help to deal with this barrier. These strategies can be as important as culturally appropriate processes in programs. Indeed, there is an overlap between the two. For those with hearing loss, what is said in culturally familiar language within a culturally familiar process is easier to understand.

Other key components of hearing loss responsive service provision include the following:

  • using highly visual communication strategies
  • minimising background noise during conversations
  • using the language clients know best
  • using ‘pre-learning’ – providing information in advance to help explain the context, so people can better understand what will be discussed
  • services having amplification devices to use as part of service delivery
  • training staff in the use of more effective communication strategies — this includes training workers to recognise hearing loss, develop necessary skills and avoid responses that prompt shame, anxiety and disengagement

We believe Closing the Gap programs will continue to fall short of targeted outcomes until they are designed to be responsive to the needs of those with hearing loss.

NACCHO Save a dates Register your event here

22 March2017 Indigenous Ear Health Workshop  in Adelaide

asohns-2017-ieh-workshop-22march2017-adelaide

The 2017 Indigenous Ear Health Workshop to be held in Adelaide in March will focus on Otitis Media (middle ear disease), hearing loss, and its significant impact on the lives of Indigenous children, the community and Indigenous culture in Australia.

The workshop will take place on 22 March 2017 at the Adelaide Convention Centre in Adelaide, South Australia.

The program features keynote addresses by invited speakers who will give presentations aligned with the workshop’s main objectives:

  • To identify and promote methods to strengthen primary prevention and care of Otitis Media (OM).
  • To engage and coordinate all stakeholders in OM management.
  • To summarise current and future research into OM pathogenesis (the manner in which it develops) and management.
  • To present the case for consistent and integrated funding for OM management.

Invited speakers will include paediatricians, public health physicians, ear nose and throat surgeons, Aboriginal health workers, Education Department and a psychologist, with OM and hearing updates from medical, audiological and medical science researchers.

The program will culminate in an address emphasising the need for funding that will provide a consistent and coordinated nationwide approach to managing Indigenous ear health in Australia.

Those interested in attending may include: ENT surgeons, ENT nurses, Aboriginal and Torres Strait Islander health workers, audiologists, rural and regional general surgeons and general practitioners, speech pathologists, teachers, researchers, state and federal government representatives and bureaucrats; in fact anyone interested in Otitis Media.

The workshop is organised by the Australian Society of Otolaryngology Head and Neck Surgery (ASOHNS) and is held just before its Annual Scientific Meeting (23 -26 March 2017). The first IEH workshop was held in Adelaide in 2012 and subsequent workshops were held in Perth, Brisbane and Sydney.

For more information go to the ASOHNS 2017 Annual Scientific Meeting Pre-Meeting Workshops section at http://asm.asohns.org.au/workshops

Or contact:

Mrs Lorna Watson, Chief Executive Officer, ASOHNS Ltd

T: +61 2 9954 5856   or  E info@asohns.org.au