NACCHO Aboriginal Health News: First Nations peoples’ COVID-19 response among the best in the world

feature tile First First Nations peoples' response among best in the world & image of Aboriginal man wearing face mask with Aboriginal flag

First Nations Peoples’ COVID-19 response among best

In a recent interview, Australia’s most respected paediatric epidemiologist, Professor Fiona Stanley, said that although Aboriginal and Torres Strait Islander people are the highest-risk people in our community, they have done exceptionally well in response to the COVID-19 pandemic. According to Professor Stanley this is because “Indigenous people took control. They lobbied the government to close remote communities, get personal protective equipment and get tested. They took their vulnerable, old Indigenous people off the streets and put them in good housing. They’re doing better than almost any population worldwide.”

To read a transcript of the full interview click here.

image of Aboriginal man wearing face mask with Aboriginal flag

Image source: NITV website.

First permanent LOV eye clinic in Kimberley

$4.7 million has been allocated towards the first permanent Lions Outback Vision (LOV) eye clinic in the Kimberley. This clinic, to be located in Broome, with outreach services to Derby, Fitzroy Crossing, Halls Creek, Kununurra, Wyndham and Warmun, will enable residents across the Kimberley to receive treatment and prevention services for serious eye diseases on country and close to home.

To read the related media release click here.

Lions Outback Image bus with door open & health professional checking someone's eyes

Image source: National Rural Health Alliance.

Aquarobics classes get results

row of Aboriginal women in a pool holding on to the side

Image source: Great Lakes Advocate.

Six month extension for COVID-19 health measures

Millions of Australians will continue to receive medical care and support in their own homes with the Commonwealth Government investing more than $2 billion to extend a range of COVID-19 health measures for a further six months, to 31 March 2021. Medicare-subsidised telehealth and pathology services, GP-led respiratory clinics, home medicines delivery, public and private hospital services will all be extended, as well as further investments in PPE. These health initiatives play a major role in detecting, preventing and treating COVID-19.

To view the media release regarding this funding click here.

health worker in mask, covid cell image superimposed

Image source: Hospital Management.

COVID-19 double standard for the Barkly

Anyinginyi Health Service has expressed concern and frustration at the granting of an exemption from compulsory supervised quarantine for workers from Melbourne brought to Tennant Creek to work outside the town. Anyinginyi General Manager, Barb Shaw, said “This breaches the NT Government’s own policy to not allow exemptions from compulsory quarantine for people coming from a hot spot” and “the government must urgently explain its decision and immediately work with the Aboriginal community, including Anyinginyi Health Service, to ensure the safety of our community”.

To view the Anyinginyi Health Service’s media release click here and click here to view a supporting media release from the Aboriginal Medical Services Alliance NT.text quote from Pat Turner 'I can't be any blunter...if COVID-19 gets into our communities, we are gone

WA grants for projects with COVID-19 focus

The first program to be funded under WA’s Future Health Research and Innovation (FHRI) Fund is now open and calling for projects with a COVID-19 focus. The FHRI Focus Grants: COVID-19 Program will initially provide up to $4 million for research and innovation that helps promote the health and wellbeing of Western Australians. The program is designed to fund research and innovation that addresses health and wellbeing challenges relevant to the COVID emergency. This could include projects related to infection prevention and control, surveillance, diagnostics and therapeutics as well as the direct or indirect impact of COVID-19 across a range of health conditions. Grants will be made available across three streams of funding – research, innovation and infrastructure.

To view the related media release click here.

COVID-109 virus cell

Image source: Medical Xpress.

Gynaecological cancer award nominations open

The rate of gynaecological cancers among Aboriginal and Torres Strait Islander women is shocking. In the case of cervical cancer for example Aboriginal and Torres Strait Islander women are 2.5 times more likely to be diagnosed with, and 3.8 times more likely to die than non-Indigenous women.

Do you know someone who has made an exceptional contribution to improving the outcomes for women affected by gynaecological cancers?

You have only one week left to make a nomination for the 2021 Jeannie Ferris Cancer Australia Recognition Award.

Applications close at 5.00 pm (AEST) Wednesday 30 September 2020.

To view further details about the award and how to nominate someone click here.

Waminda senior regional manager Krissy Falzon at desk looking at her computer

Krissy Falzon, South Coast Womens Health & Welfare Aboriginal Corporation. Image source: South Coast Register.

Simon Says Ear Health Volume 2

Volume two of AHCWA’s Simon Says series has been released. The latest resources allow you to read along with Simon and his friends to learn about the flu and how you can keep yourself and your community safe. Physical copies are  available and you are welcome to print copies as you need them.

To view volume two of the Simon Says series click here.

cartoon of Aboriginal man with family standing behind him punching giant green flu virus

Image source: AHCWA Simon Says Volume 2.

Mental health wellbeing trial using horses

A group of Broome-based Indigenous health workers are helping develop a mental wellbeing trial that uses horses to help people to express themselves openly. Known as Yawardani Jan-ga — or horses helping — the trial capitalises on the ties between Aboriginal people and horses and rodeo culture in the Kimberley to enhance the social and emotional wellbeing of youngsters while building leadership skills. It is an adapted form of the global Equine Assisted Learning model, which uses horses to build emotional skills and personal development, and will be rolled out in the region.

To read The West Australian article about the trial click here.

young Aboriginal girl on horse & Aboriginal man trainer

Image source: ABC News.

NACCHO Aboriginal Health Research Alert : @HealthInfoNet releases Summary of Aboriginal and Torres Strait Islander health status 2019 social and cultural determinants, chronic conditions, health behaviours, environmental health , alcohol and other drugs

The Australian Indigenous HealthInfoNet has released the Summary of Aboriginal and Torres Strait Islander health status 2019

This new plain language publication provides information for a wider (non-academic) audience and incorporates many visual elements.

The Summary is useful for health workers and those studying in the field as a quick source of general information. It provides key information regarding the health status of Aboriginal and Torres Strait Islander people across the following topics:

  • social and cultural determinants
  • chronic conditions
  • health behaviours
  • environmental health
  • alcohol and other drugs.

The Summary is based on HealthInfoNet‘s comprehensive publication Overview of Aboriginal and Torres Strait Islander health status 2019. It presents statistical information from the Overview in a visual format that is quick and easy for users to digest.

The Summary is available online and in hardcopy format. Please contact HealthInfoNet by email if you wish to order a hardcopy of this Summary. Other reviews and plain language summaries are available here.

Here are the key facts

Please note in an earlier version sent out 7.00 am June 15 a computer error dropped off the last word in many sentences : these are new fixed 

Key facts

Population

  • In 2019, the estimated Australian Aboriginal and Torres Strait Islander population was 847,190.
  • In 2019, NSW had the highest number of Aboriginal and Torres Strait Islander people (the estimated population was 281,107 people, 33% of the total Aboriginal and Torres Strait Islander population).
  • In 2019, NT had the highest proportion of Aboriginal and Torres Strait Islander people in its population, with 32% of the NT population identifying as Aboriginal and/or Torres Strait Islanders
  • In 2016, around 37% of Aboriginal and Torres Strait Islander people lived in major cities
  • The Aboriginal and Torres Strait Islander population is much younger than the non-Indigenous population.

Births and pregnancy outcomes

  • In 2018, there were 21,928 births registered in Australia with one or both parents identified as Aboriginal and/or Torres Strait Islander (7% of all births registered).
  • In 2018, the median age for Aboriginal and Torres Strait Islander mothers was 26.0 years.
  • In 2018, total fertility rates were 2,371 births per 1,000 for Aboriginal and Torres Strait Islander women.
  • In 2017, the average birthweight of babies born to Aboriginal and Torres Strait Islander mothers was 3,202 grams
  • The proportion of low birthweight babies born to Aboriginal and Torres Strait Islander mothers between 2007 and 2017 remained steady at around 13%.

Mortality

  • For 2018, the age-standardised death rate for Aboriginal and Torres Strait Islander people living in NSW, Qld, WA, SA and the NT was 1 per 1,000.
  • Between 1998 and 2015, there was a 15% reduction in the death rates for Aboriginal and Torres Strait Islander people in NSW, Qld, WA, SA and the NT.
  • For Aboriginal and Torres Strait Islander people born 2015-2017, life expectancy was estimated to be 6 years for males and 75.6 years for females, around 8-9 years less than the estimates for non-Indigenous males and females.
  • In 2018, the median age at death for Aboriginal and Torres Strait Islander people in NSW, Qld, WA, SA and the NT was 2 years; this was an increase from 55.8 years in 2008.
  • Between 1998 and 2015, the Aboriginal and Torres Strait Islander infant mortality rate has more than halved (from 5 to 6.3 per 1,000).
  • In 2018, the leading causes of death among Aboriginal and Torres Strait Islander people living in NSW, Qld, WA, SA and the NT were ischaemic heart disease (IHD), diabetes, chronic lower respiratory diseases and lung and related cancers.
  • For 2012-2017 the maternal mortality ratio for Aboriginal and Torres Strait Islander women was 27 deaths per 100,000 women who gave birth.
  • For 1998-2015, in NSW, Qld, WA, SA and the NT there was a 32% decline in the death rate from avoidable causes for Aboriginal and Torres Strait Islander people aged 0-74 years

Hospitalisation

  • In 2017-18, 9% of all hospital separations were for Aboriginal and Torres Strait Islander people.
  • In 2017-18, the age-adjusted separation rate for Aboriginal and Torres Strait Islander people was 2.6 times higher than for non-Indigenous people.
  • In 2017-18, the main cause of hospitalisation for Aboriginal and Torres Strait Islander people was for ‘factors influencing health status and contact with health services’ (mostly for care involving dialysis), responsible for 49% of all Aboriginal and Torres Strait Islander seperations.
  • In 2017-18, the age-standardised rate of overall potentially preventable hospitalisations for Aboriginal and Torres Strait Islander people was 80 per 1,000 (38 per 1,000 for chronic conditions and 13 per 1,000 for vaccine-preventable conditions).

Selected health conditions

Cardiovascular health

  • In 2018-19, around 15% of Aboriginal and Torres Strait Islander people reported having cardiovascular disease (CVD).
  • In 2018-19, nearly one quarter (23%) of Aboriginal and Torres Strait Islander adults were found to have high blood pressure.
  • For 2013-2017, in Qld, WA, SA and the NT combined, there were 1,043 new rheumatic heart disease diagnoses among Aboriginal and Torres Strait Islander people, a crude rate of 50 per 100,000.
  • In 2017-18, there 14,945 hospital separations for CVD among Aboriginal and Torres Strait Islander people, representing 5.4% of all Aboriginal and Torres Strait Islander hospital separations (excluding dialysis).
  • In 2018, ischaemic heart disease (IHD) was the leading specific cause of death of Aboriginal and Torres Strait Islander people living in NSW, Qld, WA, SA and the NT

Cancer

  • In 2018-19, 1% of Aboriginal and Torres Strait Islander people reported having cancer (males 1.2%, females 1.1%).
  • For 2010-2014, the most common cancers diagnosed among Aboriginal and Torres Strait Islander people living in NSW, Vic, Qld, WA and the NT were lung cancer and breast (females) cancer.
  • Survival rates indicate that of the Aboriginal and Torres Strait Islander people living in NSW, Vic, Qld, WA, and the NT who were diagnosed with cancer between 2007 and 2014, 50% had a chance of surviving five years after diagnosis
  • In 2016-17, there 8,447 hospital separations for neoplasms2 among Aboriginal and Torres Strait Islander people
  • For 2013-2017, the age-standardised mortality rate due to cancer of any type was 238 per 100,000, an increase of 5% when compared with a rate of 227 per 100,000 in 2010-2014.

Diabetes

  • In 2018-19, 8% of Aboriginal people and 7.9% of Torres Strait Islander people reported having diabetes.
  • In 2015-16, there were around 2,300 hospitalisations with a principal diagnosis of type 2 diabetes among Aboriginal and Torres Strait Islander people
  • In 2018, diabetes was the second leading cause of death for Aboriginal and Torres Strait Islander people.
  • The death rate for diabetes decreased by 0% between 2009-2013 and 2014-2018.
  • Some data sources use term ‘neoplasm’ to describe conditions associated with abnormal growth of new tissue, commonly referred to as a Neoplasms can be benign (not cancerous) or malignant (cancerous) [1].

Social and emotional wellbeing

  • In 2018-19, 31% of Aboriginal and 23% of Torres Strait Islander respondents aged 18 years and over reported high or very high levels of psychological distress
  • In 2014-15, 68% of Aboriginal and Torres Strait Islander people aged 15 years and over and 67% of children aged 4-14 years experienced at least one significant stressor in the previous 12 months
  • In 2012-13, 91% of Aboriginal and Torres Strait Islander people reported on feelings of calmness and peacefulness, happiness, fullness of life and energy either some, most, or all of the time.
  • In 2014-15, more than half of Aboriginal and Torres Strait Islander people aged 15 years and over reported an overall life satisfaction rating of at least 8 out of 10.
  • In 2018-19, 25% of Aboriginal and 17% of Torres Strait Islander people, aged two years and over, reported having a mental and/or behavioural conditions
  • In 2018-19, anxiety was the most common mental or behavioural condition reported (17%), followed by depression (13%).
  • In 2017-18, there were 21,940 hospital separations with a principal diagnosis of International Classification of Diseases (ICD) ‘mental and behavioural disorders’ identified as Aboriginal and/or Torres Strait Islander
  • In 2018, 169 (129 males and 40 females) Aboriginal and Torres Strait Islander people living in NSW, Qld, WA, SA, and the NT died from intentional self-harm (suicide).
  • Between 2009-2013 and 2014-2018, the NT was the only jurisdiction to record a decrease in intentional self-harm (suicide) death rates.

Kidney health

  • In 2018-19, 8% of Aboriginal and Torres Strait Islander people (Aboriginal people 1.9%; Torres Strait Islander people 0.4%) reported kidney disease as a long-term health condition.
  • For 2014-2018, after age-adjustment, the notification rate of end-stage renal disease was 3 times higher for Aboriginal and Torres Strait Islander people than for non-Indigenous people.
  • In 2017-18, ‘care involving dialysis’ was the most common reason for hospitalisation among Aboriginal and Torres Strait Islander people.
  • In 2018, 310 Aboriginal and Torres Strait Islander people commenced dialysis and 49 were the recipients of new kidneys.
  • For 2013-2017, the age-adjusted death rate from kidney disease was 21 per 100,000 (NT: 47 per 100,000; WA: 38 per 100,000) for Aboriginal and Torres Strait Islander people living in NSW, Qld, WA, SA and NT
  • In 2018, the most common causes of death among the 217 Aboriginal and Torres Strait Islander people who were receiving dialysis was CVD (64 deaths) and withdrawal from treatment (51 deaths).

Injury, including family violence

  • In 2012-13, 5% of Aboriginal and Torres Strait Islander people reported having a long-term condition caused by injury.
  • In 2018-19, 16% of Aboriginal and Torres Strait Islander people aged 15 years and over had experienced physical harm or threatened physical harm at least once in the last 12 months.
  • In 2016-17, the rate of Aboriginal and Torres Strait Islander hospitalised injury was higher for males (44 per 1,000) than females (39 per 1,000).
  • In 2017-18, 20% of injury-related hospitalisations among Aboriginal and Torres Strait Islander people were for assault.
  • In 2018, intentional self-harm was the leading specific cause of injury deaths for NSW, Qld, SA, WA, and NT (5.3% of all Aboriginal and Torres Strait Islander deaths).

Respiratory health

  • In 2018-19, 29% of Aboriginal and Torres Strait Islander people reported having a long-term respiratory condition .
  • In 2018-19, 16% of Aboriginal and Torres Strait Islander people reported having asthma.
  • In 2014-15, crude hospitalisation rates were highest for Aboriginal and Torres Strait Islander people presenting with influenza and pneumonia (7.4 per 1,000), followed by COPD (5.3 per 1,000), acute upper respiratory infections (3.8 per 1,000) and asthma (2.9 per 1,000).
  • In 2018, chronic lower respiratory disease was the third highest cause of death overall for Aboriginal and Torres Strait Islander people living in NSW, Qld, WA, SA and the NT

Eye health

  • In 2018-19, eye and sight problems were reported by 38% of Aboriginal people and 40% of Torres Strait Islander people.
  • In 2018-19, eye and sight problems were reported by 32% of Aboriginal and Torres Strait Islander males and by 43% of females.
  • In 2018-19, the most common eye conditions reported by Aboriginal and Torres Strait Islanders were hyperopia (long sightedness: 22%), myopia (short sightedness: 16%), other diseases of the eye and adnexa (8.7%), cataract (1.4%), blindness (0.9%) and glaucoma (0.5%).
  • In 2014-15, 13% of Aboriginal and Torres Strait Islander children, aged 4-14 years, were reported to have eye or sight problems.
  • In 2018, 144 cases of trachoma were detected among Aboriginal and Torres Strait Islander children living in at-risk communities in Qld, WA, SA and the NT
  • For 2015-17, 62% of hospitalisations for diseases of the eye (8,274) among Aboriginal and Torres Strait Islander people were for disorders of the lens (5,092) (mainly cataracts).

Ear health and hearing

  • In 2018-19, 14% of Aboriginal and Torres Strait Islander people reported having a long-term ear and/or hearing problem
  • In 2018-19, among Aboriginal and Torres Strait Islander children aged 0-14 years, the prevalence of otitis media (OM) was 6% and of partial or complete deafness was 3.8%.
  • In 2017-18, the age-adjusted hospitalisation rate for ear conditions for Aboriginal and Torres Strait Islander people was 1 per 1,000 population.

Oral health

  • In 2014-15, the proportion of Aboriginal and Torres Strait Islander children aged 4-14 years with reported tooth or gum problems was 34%, a decrease from 39% in 2008.
  • In 2012-2014, 61% of Aboriginal and Torres Strait Islander children aged 5-10 years had experienced tooth decay in their baby teeth, and 36% of Aboriginal and Torres Strait Islander children aged 6-14 years had experienced tooth decay in their permanent teeth.
  • In 2016-17, there were 3,418 potentially preventable hospitalisations for dental conditions for Aboriginal and Torres Strait Islander The age-standardised rate of hospitalisation was 4.6 per 1,000.

Disability

  • In 2018-19, 27% of Aboriginal and 24% of Torres Strait Islander people reported having a disability or restrictive long-term health
  • In 2018-19, 2% of Aboriginal and 8.3% of Torres Strait Islander people reported a profound or severe core activity limitation.
  • In 2016, 7% of Aboriginal and Torres Strait Islander people with a profound or severe disability reported a need for assistance.
  • In 2017-18, 9% of disability service users were Aboriginal and Torres Strait Islander people, with most aged under 50 years (82%).
  • In 2017-18, the primary disability groups accessing services were Aboriginal and Torres Strait Islander people with a psychiatric condition (24%), intellectual disability (23%) and physical disability (20%).
  • In 2017-18, 2,524 Aboriginal and Torres Strait Islander National Disability Agreement service users transitioned to the National Disability Insurance Scheme.

Communicable diseases

  • In 2017, there were 7,015 notifications for chlamydia for Aboriginal and Torres Strait Islander people, accounting for 7% of the notifications in Australia
  • During 2013-2017, there was a 9% and 9.8% decline in chlamydia notification rates among males and females (respectively).
  • In 2017, there were 4,119 gonorrhoea notifications for Aboriginal and Torres Strait Islander people, accounting for 15% of the notifications in Australia.
  • In 2017, there were 779 syphilis notifications for Aboriginal and Torres Strait Islander people accounting for 18% of the notifications in Australia.
  • In 2017, Qld (45%) and the NT (35%) accounted for 80% of the syphilis notifications from all jurisdictions.
  • In 2018, there were 34 cases of newly diagnosed human immunodeficiency virus (HIV) infection among Aboriginal and Torres Strait Islander people in Australia .
  • In 2017, there were 1,201 Aboriginal and Torres Strait Islander people diagnosed with hepatitis C (HCV) in Australia
  • In 2017, there were 151 Aboriginal and Torres Strait Islander people diagnosed with hepatitis B (HBV) in Australia
  • For 2013-2017 there was a 37% decline in the HBV notification rates for Aboriginal and Torres Strait Islander people.
  • For 2011-2015, 1,152 (14%) of the 8,316 cases of invasive pneumococcal disease (IPD) were identified as Aboriginal and Torres Strait people .
  • For 2011-2015, there were 26 deaths attributed to IPD with 11 of the 26 deaths (42%) in the 50 years and over age-group.
  • For 2011-2015, 101 (10%) of the 966 notified cases of meningococcal disease were identified as Aboriginal and Torres Strait Islander people
  • For 2006-2015, the incidence rate of meningococcal serogroup B was 8 per 100,000, with the age- specific rate highest in infants less than 12 months of age (33 per 100,000).
  • In 2015, of the 1,255 notifications of TB in Australia, 27 (2.2%) were identified as Aboriginal and seven (0.6%) as Torres Strait Islander people
  • For 2011-2015, there were 16 Aboriginal and Torres Strait Islander people diagnosed with invasive Haemophilus influenzae type b (Hib) in Australia
  • Between 2007-2010 and 2011-2015 notification rates for Hib decreased by around 67%.
  • In 2018-19, the proportion of Aboriginal and Torres Strait Islander people reporting a disease of the skin and subcutaneous tissue was 2% (males 2.4% and females 4.0%).

NACCHO Aboriginal #EyeHealth News Alerts : @IEHU_UniMelb The #ClosetheGap for Vision by 2020: The Gap and Beyond: National Conference 2020 goes virtual : View presentations from Minister @GregHuntMP @profhughrt Dr Janine Mohamed and Dr Kris Rallah-Baker

Since the postponement of the Close the Gap for Vision by 2020: The Gap and Beyond: National Conference 2020, which was due to take place in Adelaide on the 18 and 19 March 2020, Indigenous Eye Health has been establishing suitable dates for the rescheduling of the conference, together with co-hosts Aboriginal Health Council of South Australia (AHCSA).

We look forward to sharing this further advice regarding the next conference as soon as we can.

Original press release HERE

In lieu of being able to hear the keynote presentations face-to-face at the conference, a number of our keynote speakers have kindly recorded presentations and video messages for conference delegates and the Indigenous eye health sector more broadly.

Please note that these presentations have been recorded at different times, including prior to the event and the conference postponement announcement, and so should be viewed with the understanding that they are not contemporary messages.

Professor Hugh Taylor AC

 

The Hon. Greg Hunt MP

 

Dr Janine Mohamed

Over the past 20 years, Dr Janine Mohamed has worked in nursing, management, project management, and workforce and health policy in the Aboriginal and Torres Strait Islander health sector.

Many of these years have been spent in the Aboriginal Community Controlled Health sector at state, national and international levels, and most recently as the CEO at the Congress of Aboriginal and Torres Strait Islander Nurses and Midwives (CATSINaM).

Dr Mohamed is now based in Melbourne and is the CEO of the Lowitja Institute. She was awarded an Atlantic Fellows for Social Equity Fellowship in 2019, and, in January 2020, a Doctorate of Nursing honoris causa by Edith Cowan University.

 

Dr Kris Rallah-Baker

Dr Kris Rallah-Baker is a Yuggera/Biri-Gubba-Juru man. Born in Canberra, he moved to Brisbane with his parents at the age of four, where he and his brother completed their schooling. Dr Rallah-Baker was a bright student who did well in all his subjects, and at the end of high school he chose to pursue further studies in medicine.

He’d been inspired as a young boy to join the medical profession after his nanna told him how her mother had passed away from pneumonia when his nanna was just 12-years-old.

As part of the Stolen Generation, she had been traumatised and had refused to see white doctors. Because of this, she didn’t get the medical assistance she needed, causing her to pass away before her time. “Her story was told frequently in our family and I credit her with the inspiration for me to become a medical doctor,” Dr Rallah-Baker says.

Dr Rallah-Baker knows firsthand how important it is to have Aboriginal and Torres Strait Islander Peoples on the other side of the doctor’s desk. “Having Aboriginal ophthalmologists at the table brings a new perspective. These patients could be like me, they could be my uncle, they could be my cousins.

“The gap itself won’t be closed by me, but it helps the conversation move along.”

We thank them for taking the time to record their presentations so that they can be shared with you.

We think they are great and capture important information and messages.

Indigenous Eye Health and the Aboriginal Health Council of South Australia (AHCSA) are pleased to present the ‘Close the Gap for Vision by 2020: The Gap and Beyond: National Conference 2020’ keynote presentation videos.

You are welcome to contact Guy Gillor (guy.gillor@unimelb.edu.au) or Nick Wilson (nick.wilson@unimelb.edu.au) for more information about the videos, future conference considerations or other related matters.

View Conference Program

NACCHO leads PBS listing of medication to improve #eyehealth for Aboriginal and Torres Strait Islander people : Download our NACCHO Press Release HERE

“Aboriginal and Torres Strait Islander people are overrepresented in rates of eye disease and vision problems.

They are amongst the most common long-term health conditions reported by our communities and most of the vision loss associated with these issues is preventable.

“This successful collaboration with experts and industry is important to NACCHO as access to the right medication and the best medical treatment for Aboriginal and Torres Strait Islander peoples, is our top priority.

In order to close the gap in health rates and experiences, more actions like this in the right direction must be made.”

Dr Dawn Casey, Deputy CEO of NACCHO Download Press Release 2 March 2020

Read over 50 Aboriginal Eye Health articles published by NACCHO

Read Aboriginal Health and ACCHO Pharmacies articles published by NACCHO

The National Aboriginal Community Controlled Health Organisation (NACCHO) is proud to have led a successful submission to the Pharmaceutical Benefits Advisory Committee (PBAC) for an expansion to the listing of Prednefrin Forte on the Pharmaceutical Benefits Scheme (PBS).

This item can now be prescribed on the PBS for Aboriginal and Torres Strait Islander patients as of 1 March 2020.

NACCHO worked with a range of experts and stakeholders to seek listing of Prednefrin Forte on the PBS for treatment of post-operative eye-inflammation.

This listing will mean that there is a greater range and better affordability of anti-inflammatory eye drops for Aboriginal and Torres Strait Islander people.

Eye disease is more common in Aboriginal and Torres Strait Islander people compared to other Australians; eye health outcomes are poorer and cataracts more prevalent. Prednefrin Forte (prednisolone and phenylephrine eye drops) is a medication used to treat eye inflammation and swelling that is often considered first-line therapy by ophthalmologists after cataract surgery.

It has advantageous properties and pack size when compared to other similar medicines.

Allergan Managing Director, Nathalie McNeil said, “It has been a pleasure for Allergan to collaborate with NACCHO on this PBAC submission. We are excited about Prednefrin Forte’s contribution towards improved health outcomes for the Aboriginal and Torres Strait Islander communities.”

Vision 2020 Australia CEO Judith Abbott said, “Aboriginal and Torres Strait Islander people currently experience blindness and low vision at three times the rate of non-Indigenous Australians.

“As Strong eyes, strong communities: a five-year plan for Aboriginal and Torres Strait Islander eye health and vision highlights, improving access to timely, culturally sensitive and affordable eye health care is of vital importance.

We welcome this change to current drug scheduling, which will enable Aboriginal and Torres Strait Islander people to access a broader and more affordable range of eye medications, when they are needed.”

NACCHO Media-Statement – NACCHO leads PBS listing of medication to improve eye health for Aboriginal and Torres Strait Islander peopleDownload

 

NACCHO Aboriginal Torres Strait Islander Children’s Health : Download @AusHumanRights Children’s Rights Report 2019 — In Their Own Right : Our kids continue to face significant disadvantage across a range of domains

“ Aboriginal and Torres Strait Islander children in Australia continue to face significant disadvantage across a range of domains relevant to their rights and wellbeing, including in relation to health and education outcomes, discrimination, exposure to family violence, and overrepresentation in child protection and youth justice systems.

Most recommendations made throughout this report apply to all children living in Australia, including Aboriginal and Torres Strait Islander children.

However, given the significant disadvantage experienced by Aboriginal and Torres Strait Islander children, this chapter (12 ) contains recommendations which are specific to their circumstances.”

Extract from Australia’s first Children’s Commissioner, Megan Mitchell who today launched her final report – one of the most comprehensive assessments of children’s rights ever produced in Australia.

See Pages 256 to 271 Aboriginal and Torres Strait Islander children or read Health extract below

Download full report 300 + Pages 

childrensrightsreport_2019_ahrc

Read over 380 Aboriginal Children’s Health articles published by NACCHO over the past 8 years

AHRC Press Release 

The report makes clear that the mental health of Australian children is not being cared for sufficiently and that Governments must do more to ensure children’s wellbeing.

Commissioner Mitchell said: “Not only do children require better access to mental health services, but they also need earlier intervention and higher quality care.”

The report calls on the Federal Government to develop a National Plan for Child Wellbeing and to appoint a Cabinet level Minister with responsibility for children’s issues at the national level.

National data shows one in seven children aged four to 17 were diagnosed with mental health disorders in a 12-month period, and rates of suicide and self-harm are increasing.

Suicide was the leading cause of death for children aged five to 17 in 2017, and Indigenous children accounted for almost 20% of all child suicides. There were 35,997 hospital admissions for self-harm in the ten years to 2017.

Other urgent concerns highlighted in the report include that, from 2013 to 2017 there was a 27% increase in reported substantiations of child abuse and neglect. The number of children in out-of- home care has increased by 18% over the last five years. Also, approximately 17% of children under the age of 15 live in poverty.

Commissioner Mitchell said: “The increase in neglect and abuse of children is a particularly worrying trend, as is the increase in children living in out of home care. We must do better.”

The report shows children in vulnerable situations suffer most through a lack of government focus. This includes Indigenous children, children with a disability, those from culturally and linguistically diverse backgrounds, and LGBTI children.

Commissioner Mitchell said: “There is a gap between the rights we have promised vulnerable children and how those rights are implemented. It is vital that we address the gap in order to better protect children’s rights.”

Attorney General Christian Porter tabled the report in Parliament on Thursday, 6 February.

Aboriginal and Torres Strait Islander peoples are the oldest civilisation on earth, extending back over 65,000 years. Aboriginal and Torres Strait Islander peoples are vastly diverse in culture, language and in spiritual beliefs.[i] At the time of colonisation, there were over 500 separate Aboriginal and Torres Strait Islander nations, over 250 languages spoken, and 800 dialectical varieties.[ii]

In its Concluding Observations (2019), the Committee on the Rights of the Child urged the Australian Government to ensure that Aboriginal and Torres Strait Islander children and their communities are meaningfully involved in the planning, implementation and evaluation of policies concerning them.[iii]

Health Inequality 

The disparity in health status between Aboriginal and Torres Strait Islander children and their non-Indigenous counterparts remains a crucial human rights issue within Australia.[iv] This is despite the investment in Closing the Gapa national strategy to reduce health and related inequalities for Aboriginal and Torres Strait Islander peoples, which has been in place since 2008.

In its Concluding Observations (2019), the Committee on the Rights of the Child urged the Australian Government to promptly address the disparities in the health status of Aboriginal and Torres Strait Islander children.[v]

The Australian Institute of Health and Welfare (AIHW) reported in 2018 that there are major gaps in data on important health issues affecting Aboriginal and Torres Strait Islander children.[vi] This includes culturally-appropriate data that measures wellbeing, treatment of mental health conditions, sexual health (including use of contraception and sexual health services), and use of primary health care services.[vii]

It pointed out that data for Aboriginal and Torres Strait Islander children aged 10–14 years is limited, compared to those aged 15–19 and 20–24, as both the Australian Aboriginal and Torres Strait Islander People Health Survey 2012–13 and the National Aboriginal and Torres Strait Islander Health Survey 2014–15 were more focused on adults.[viii] 

In 2018–19, the National Aboriginal and Torres Strait Islander Health Survey (NATSIHS) has, for the first time, included up to two child members of each selected household aged 0 to 17.[ix] The results from NATSIHS 2018–19 will be available in late 2019.[x] The inclusion of those aged 0 to 17 is a welcome addition.

The Australian Human Rights Commission (the Commission) also welcomes Mayi Kuwayu: The National Study of Aboriginal and Torres Strait Islander Wellbeing and hopes that it will collect data on children aged 0–17.[xi]

Child mortality

Since the Closing the Gap target baseline was set in 2008, Aboriginal and Torres Strait Islander child mortality rates have declined by 10%.[xii]

However, the gap between Aboriginal and Torres Strait Islander children and non-Indigenous children has not narrowed, because the non-Indigenous rate has declined at a faster rate.[xiii] It is for this reason that measuring the gap is not always helpful.

Aboriginal and Torres Strait Islander infants are three times as likely as non-Indigenous infants to die between one and six months of age, and twice as likely to die for all other age categories except for one day to one week old, where the risks are equivalent.[xiv]

Aboriginal and Torres Strait Islander children are 2.1 times more likely to die before their fifth birthday compared to their non-Indigenous peers.[xv]

Ear disease

Ear disease is a significant health issue facing Aboriginal and Torres Strait Islander children. Aboriginal and Torres Strait Islander children aged 0–14 are 2.9 times more likely to have long-term ear or hearing problems compared with non-Indigenous children.[xvi]

Limited access to primary health care for Aboriginal and Torres Strait Islander children can result in delayed diagnosis, treatment and management of health conditions.

Long-term ear or hearing problems are linked to delays in speech and language development.[xvii] These can have lasting impacts on educational and workforce outcomes.

The AIHW pointed out in its report on Australia’s Health 2018 that there is no national statistical profile of ear disease and associated hearing loss for Aboriginal and Torres Strait children based on diagnostic assessment. It argued that, without good-quality surveillance, it is difficult to understand the size and key determinants associated with the hearing problem.[xviii]

Obesity

The most recent data available from the AIHW shows that in 2012–13, 30% of Aboriginal and Torres Strait Islander children aged 2–14 were overweight or obese, compared with 25% of their non-Indigenous counterparts.[xix]

One in five (20%) Aboriginal and Torres Strait Islander children aged 2–14 were overweight and one in ten (10%) were obese. At age 15–17, 35% were overweight or obese. About one in five (21%) were overweight, while about one in seven (14%) were obese.[xx]

Of Aboriginal and Torres Strait Islander boys aged 2–14, 18% were overweight and 10% were obese. At age 15–17, 21% were overweight and 17% were obese. Among girls aged 2–14 and those aged 15–17, 21% were overweight and 11% were obese.[xxi]

Children with obesity are more likely to be obese as adults and have an ‘increased risk of developing both short and long-term health conditions, such as Type 2 diabetes and cardiovascular disease’.[xxii]

Mental health

The likelihood of probable serious mental illness has been found to be consistently higher among Aboriginal and Torres Strait Islander children compared to their non-Indigenous peers.[xxiii]

National Coronial Information System data show that Aboriginal and Torres Strait Islander children aged 4–17 accounted for 19.2% of all child deaths due to suicide between 2007–15. [xxiv] Specifically, there were:

  • one to three deaths in the 4–9 year age range
  • one to three deaths in the 10–11 year age range
  • 12 deaths in the 12–13 year age range
  • 45 deaths in the 14–15 year age range
  • 62 deaths in the 16–17 year age range. [xxv]

The AIHW collects hospital data on intentional self-harm. Children who engage in intentional self-harm, with or without suicidal intent, often only experience hospitalisation because they cannot manage their injury without medical intervention. Approximately 8% of hospitalisations for intentional self-harm between 2007–08 and 2016–17 involved Aboriginal and Torres Strait Islander children.[xxvi] Of the 2,928 hospitalisations for Aboriginal and Torres Strait Islander children, 17 (<1%) were for children aged 3–9, 859 (29%) were for children aged 3–14 and 2,052 (70%) were for children aged 15–17.[xxvii]

In its Concluding Observations (2019), the Committee on the Rights of the Child called on the Australian Government to prioritise mental health service delivery to Aboriginal and Torres Strait Islander children, including addressing the underlying causes of children’s suicide and poor mental health.[xxviii]

Sexual health

The fertility rates of Aboriginal and Torres Strait Islander teenagers are approximately 5.8 times the rate for non-Indigenous teenagers (52 per 1,000 females compared to nine per 1,000 females).[xxix]

The Committee on the Rights of the Child in its Concluding Observations (2019) specifically called for the Australian Government to strengthen its measures to prevent teenage pregnancies among Aboriginal and Torres Strait Islander girls, including by providing culturally sensitive and confidential medical advice and services. [xxx]

The levels of sexually transmitted infections (STIs) in children, especially those from Aboriginal and Torres Strait Islander communities, are particularly concerning. The rates of infection within these communities are recognised as being the highest of any identifiable population in Australia.[xxxi]

For example, 2016 data from the Northern Territory, shows there were 161 notified cases of chlamydia in Aboriginal children under 16 years compared to three cases in non-Indigenous children; 186 notified cases of gonorrhoea in Aboriginal children under 16 years compared to one case in a non-Indigenous child; 26 notified cases of syphilis in Aboriginal children under 16 years with no notified cases for non-Indigenous children; and 240 notified cases of trichomoniasis in Aboriginal children under 16 years with no notified cases for non-Indigenous children.[xxxii]

Aboriginal Medical Services play a crucial role in providing health services for Aboriginal and Torres Strait Islander children. Research has suggested that ‘one of the most productive ways forward with regards to improving knowledge and increasing safe sex practice among young Aboriginal people is through community-controlled organisations’.[xxxiii]

[i] Reconciliation Australia, Share Our Pride, Our shared history (2019) <http://shareourpride.reconciliation.org.au/sections/our-shared-history/&gt;.

[ii] Australian Institute of Aboriginal and Torres Strait Islander Studies, Indigenous Australian Languages, 2019 (14 March 2019) <https://aiatsis.gov.au/explore/articles/indigenous-australian-languages&gt;.

[iii] United Nations Committee on the Rights of the Child, Concluding Observations on the Combined Fifth and Sixth Periodic Reports of Australia, 82nd Sess, UN Doc CRC/C/AUS/CO/5-6 (30 September 2019) para 46(a).

[iv] Australian Institute of Health and Welfare, Trends in Indigenous Mortality and Life Expectancy 2001–2015 (Report, 1 December 2017) vii.

[v] United Nations Committee on the Rights of the Child, Concluding Observations on the Combined Fifth and Sixth Periodic Reports of Australia, 82nd Sess, UN Doc CRC/C/AUS/CO/5-6 (30 September 2019) para 36(a).

[vi] Australian Institute of Health and Welfare, Aboriginal and Torres Strait Islander adolescent and youth health and wellbeing 2018 (Report, 2018) xii.

[vii] Australian Institute of Health and Welfare, Aboriginal and Torres Strait Islander adolescent and youth health and wellbeing 2018 (Report, 2018) xii.

[viii] Australian Institute of Health and Welfare, Aboriginal and Torres Strait Islander adolescent and youth health and wellbeing 2018 (Report, 2018) 6.

[ix] Australian Bureau of Statistics, National Aboriginal and Torres Strait Islander Health Survey (2018) <www.abs.gov.au/websitedbs/D3310114.nsf/Home/Survey+Participant+Information+-+National+Aboriginal+and+Torres+Strait+Islander+Health+Survey>.

[x] Australian Bureau of Statistics, National Aboriginal and Torres Strait Islander Health Survey (2018) <www.abs.gov.au/websitedbs/D3310114.nsf/Home/Survey+Participant+Information+-+National+Aboriginal+and+Torres+Strait+Islander+Health+Survey>.

[xi] Mayi Kuwayu: The National Study of Aboriginal and Torres Strait Islander Wellbeing (2019) <https://mkstudy.com.au/&gt;.

[xii] Department of Prime Minister and Cabinet, Closing the Gap Report: Prime Minister’s Report 2019 (Report, 2019) 10 <https://ctgreport.niaa.gov.au/&gt;.

[xiii] Department of Prime Minister and Cabinet, Closing the Gap Report: Prime Minister’s Report 2019 (2019) 10 <https://ctgreport.niaa.gov.au/&gt;.

[xiv] Australian Institute of Health and Welfare, Australia’s health 2018 (Report, 2018) 317 <www.aihw.gov.au/getmedia/7c42913d-295f-4bc9-9c24-4e44eff4a04a/aihw-aus-221.pdf.aspx?inline=true>.

[xv] Australian Institute of Health and Welfare, Australia’s health 2018 (Report, 2018) 31 <www.aihw.gov.au/reports/australias-health/australias-health-2018/contents/table-of-contents>.

[xvi] Australian Institute of Health and Welfare, Australia’s health 2018 (Report, 2018) 322 <www.aihw.gov.au/reports/australias-health/australias-health-2018/contents/table-of-contents>.

[xvii] Australian Institute of Health and Welfare, Australia’s health 2018 (Report, 2018) 321 <www.aihw.gov.au/reports/australias-health/australias-health-2018/contents/table-of-contents>.

[xviii] Australian Institute of Health and Welfare, Australia’s health 2018 (Report, 2018) 329 <www.aihw.gov.au/reports/australias-health/australias-health-2018/contents/table-of-contents>.

[xix] Australian Institute of Health and Welfare, A Picture of Overweight and Obesity in Australia 2017 (Report, 2017) 14 <https://www.aihw.gov.au/getmedia/172fba28-785e-4a08-ab37-2da3bbae40b8/aihw-phe-216.pdf.aspx?inline=true&gt;.

[xx] Australian Institute of Health and Welfare, Overweight and obesity: an interactive insight: A web report (19 July 2019) <www.aihw.gov.au/reports-data/behaviours-risk-factors/overweight-obesity/overview>.

[xxi] Australian Institute of Health and Welfare, Overweight and obesity: an interactive insight: A web report (19 July 2019) <www.aihw.gov.au/reports-data/behaviours-risk-factors/overweight-obesity/overview>.

[xxii] Australian Bureau of Statistics, Children Who are Overweight or Obese (2009) 1 <www.ausstats.abs.gov.au/ausstats/subscriber.nsf/LookupAttach/4102.0Publication24.09.093/$File/41020_Childhoodobesity.pdf>.

[xxiii] Mission Australia, Youth Survey Report 2017 (2017) 4 <www.missionaustralia.com.au/publications/research/young-people>.

[xxiv] National Coronial Information System. Report prepared for the National Children’s Commissioner on Intentional Self-Harm Fatalities of Persons under 18 in Australia 2007–2015. Report prepared on 07/02/2018.

[xxv] National Coronial Information System. Report prepared for the National Children’s Commissioner on Intentional Self-Harm Fatalities of Persons under 18 in Australia 2007–2015. Report prepared on 07/02/2018.

[xxvi] Australian Institute of Health and Welfare, Data request Specification on self-harm prepared for the Australian Human Rights Commission 2007-2008 to 2016-17 (2018).

[xxvii] Australian Institute of Health and Welfare, Data request Specification on self-harm prepared for the Australian Human Rights Commission 2007-2008 to 2016-17 (2018).

[xxviii] United Nations Committee on the Rights of the Child, Concluding Observations on the Combined Fifth and Sixth Periodic Reports of Australia, 82nd Sess, UN Doc CRC/C/AUS/CO/5-6 (30 September 2019) para 38(a), (b).

[xxix] Australian Institute of Health and Welfare, Children’s Headline Indicators: Teenage Births (2018) <www.aihw.gov.au/reports/children-youth/childrens-headline-indicators/contents/indicator-14>.

[xxx] United Nations Committee on the Rights of the Child, Concluding Observations on the Combined Fifth and Sixth Periodic Reports of Australia, 82nd Sess, UN Doc CRC/C/AUS/CO/5-6 (30 September 2019) para 39(a).

[xxxi] Royal Commission and Board of Inquiry into the Protection and Detention of Children in the Northern Territory (Final Report, 2017) vol 3b, 82.

[xxxii] Royal Commission and Board of Inquiry into the Protection and Detention of Children in the Northern Territory (Final Report, 2017) vol 3b, 82.

[xxxiii] The Kirby Institute, Sexual Health and Relationships in Young Aboriginal and Torres Strait Islander People: Results from the first national study assessing knowledge, risk practices and health service use in relation to sexually transmitted infections and blood borne viruses (Report, 2014) 54.

NACCHO Aboriginal #EyeHealth #RANZCO2019: Download The release of the @IEHU_UniMelb 2019 Annual Update on the Implementation of the Roadmap to Close the Gap for Vision reveals that we are on track to #closingthegap for vision for Indigenous Australians by the end of next year

We’re making some really good progress and we’ve seen that what’s been recommended and implemented actually works.

Over the last 10 years, the number of community hotspots for trachoma has reduced from 54 to 13. Trachoma is easily spread between children so ongoing efforts are needed to maintain improvements in hygiene.

As we approach the final year of the steps still need to be taken to guarantee equity by 2020.

We have seen an increase in funding and a three-fold increase in outreach of eye services, but to meet community needs we still have another 25 per cent to go.

The work being done by the Aboriginal and Torres Strait Islander health organisations and all of our partners in eye health has been instrumental in this progress.

 We cannot over emphasise the importance of linking primary health care with specialist eye health services.

Ongoing support is vital to ensuring the expanded services are firmly embedded in the ACCHOs and other primary care providers to make sure that the changes are sustainable over the long term. It will not be possible to close the gap for vision without additional funding

Nearly eight years since launching his plan to improve the eye health of Indigenous Australians, University of Melbourne ophthalmologist Hugh Taylor said significant advances are also being made to meet the WHO target for the elimination of trachoma – a blinding eye infection that’s only found in Indigenous communities in Australia – by the end of 2020

See Professor Hugh Taylor’s editorial HERE 

Picture above in banner : IEH has developed a ‘toblerone’ (or ‘tent’ shaped) desktop resource and an ‘Asking the Question’ (AtQ) Information Sheet that aims to highlight ways to improve eye care service delivery in mainstream practices and clinics with appropriate identification of Aboriginal and Torres Strait Islander status. See Part 2 below 

See all Aboriginal Eye Health Articles here

Professor Taylor highlighted Vision 2020 Australia initiatives as priority areas for government.

“Vision 2020 Australia and its members have launched a five-year plan to improve Indigenous eye health,” Professor Taylor said. “The Strong Eyes, Strong Communities plan calls for $85.5 million to empower ACCHOs, build on our work to close the gap for vision and provide a framework and advocacy program until 2024.

Australia is on track to close the gap for vision for Indigenous Australians by the end of next year, but this won’t be achieved without ongoing support for long-term solutions, according to a new report.

 

The 2019 Annual Update on the Implementation of the Roadmap to Close the Gap for Vision reveals that : Download HERE

2019-AnnualUpdate

  • 50 per cent of systemic issues identified in Indigenous eyecare have been fixed. Progress is being made on all of the intermediary steps, with almost 80 per cent complete
  • Outreach eye examinations received by Indigenous Australians have almost tripled in the the last six years
  • Cataract surgery rates have increased nearly 5 times since 2008, however a further 2400 cataract surgeries are required each year to meet the population need
  • Indigenous patients still wait 50 per cent longer for cataract surgery in public hospitals, promoting calls for more timely access, resources and case management
  • The number of Indigenous Australians with diabetes receiving annual eye checks for diabetic retinopathy – which causes vision loss and blindness – has more than doubled over the last 10 years. With 155 retinal cameras being provided to Aboriginal Community Controlled Health Organisations (ACCHO), these rates will continue to improve

Subsidised schemes are being reviewed and strengthened to improve access to prescription glasses

Doctor Kris Rallah-Baker launch the 2019 update on implementation of the Roadmap to Close the Gap for Vision

The 2019 Annual Update on the Implementation of the Roadmap to Close the Gap for Vision was launched today at the Royal Australian and New Zealand College of Ophthalmologists 51th Annual Scientific Congress in Sydney.

Part 2

Indigenous eye health advocates have designed a new tool to help eyecare practices initiate conversations with patients who identify as Aboriginal or Torres Strait Islander.

The University of Melbourne’s Indigenous Eye Health (IEH) unit is now distributing a desktop resource that has been specially developed for mainstream optometry and ophthalmology practices. The group aims to promote cultural safety and ensure Indigenous patients can access appropriate care.

The two-sided, ‘tent-shaped’ resource has been designed in consultation with the Indigenous community and works as a prompt by asking patients: “Are you of Aboriginal or Torres Strait Islander origin?”. The staff-facing side reminds practice employees to ask the same question to each patient, while remaining sensitive, confident and respectful.

“The prime motivation is to try help the professions of optometry and ophthalmology, and the practices they run, create a setting that Aboriginal and Torres Strait Islander people would consider to be a culturally safe place to receive care,” optometrist and IEH deputy director Mr Mitchell Anjou told Insight.

“There’s no resource like this in mainstream eyecare, and we are now hoping to stimulate conversations within practices about improved approaches to service and care for Aboriginal and Torres Strait Island people who present at their practices.”

While progress has been made, Indigenous communities continue to experience avoidable vision loss and blindness at three times the rate of the non-Indigenous population.

Anjou said stronger data and evidence could assist in eye service planning and delivery, helping to further reduce Australia’s eye health disparity. Improved identification could also have a positive impact in terms of clinical management.

This includes access to targeted services for Indigenous patients such as subsidised spectacle schemes, prioritisation for cataract surgery, and specific Medicare rebates or funding.

Anjou said other specific service options may be available, including access to Aboriginal hospital liaison officers, Aboriginal health workers and transport support.

“In some cases, clinical guidelines vary between Aboriginal and Torres Strait Islander Peoples and other Australians, for example the frequency of retinal screening for people with diabetes, which is annual for Aboriginal patients and once every two years for other patients,” Anjou said.

The new resource is supported by Optometry Australia, RANZCO and Vision 2020 Australia.

It can be accessed HERE

NACCHO Aboriginal #EyeHealth : @FredHollows Foundation launches new Five Year Country strategy investing at least $40 million to close the eye health gap for Aboriginal and Torres Strait Islander Peoples

While we have made significant progress over the last decade, we still have much more to do to achieve full eye health equity.

Fred was passionate about partnering with Aboriginal and Torres Strait Islander Peoples and involving them in health programs that affected them.

This is a huge focus for us over the next five years, to empower Aboriginal Community Controlled Health Services by giving them the support and tools they need to provide their own quality eye health services.

Last year, The Fred Hollows Foundation contributed to more than 1,000 cataract surgeries for Aboriginal and Torres Strait Islander Peoples and doubled the number of cataract surgeries in the Katherine region of the Northern Territory.

We thank the Australian Government and our partners for supporting our work and we ask that they join in our efforts to close the gap on eye health for good.”

Launching the strategy on The Foundation’s 27th Anniversary, Indigenous Australia Program Manager Shaun Tatipata pictured above said Australia’s First Peoples are three times more likely to go blind than other Australians and 12 times more likely to have cataract, the world’s leading cause of blindness

The launch was held at the Aboriginal Medical Service in Sydney’s Redfern, to which Fred donated resources when it was first established.

Read over 50 Aboriginal Eye Health articles published by NACCHO over past 7 years

See the Indigenous Australia Program Five Year Country Strategy here: Or Download

Indigenous-Australia-Strategy-2020-2024

The Fred Hollows Foundation pledges its biggest ever investment to Aboriginal and Torres Strait Islander eye health

The Fred Hollows Foundation today committed its biggest ever investment to Aboriginal and Torres Strait Islander eye health with the launch of its new Indigenous Australia Program Five Year Country Strategy.

The strategy will see The Foundation invest at least $40 million over the next five years to closing the eye health gap for Aboriginal and Torres Strait Islander Peoples.

Dignitaries present included Shadow Minister for Indigenous Australians Linda Burney and Gabi Hollows AO, Founding Director of The Foundation.

The Foundation’s CEO Ian Wishart said Fred’s pioneering spirit was very much alive in the new Country Strategy, which seeks to identify and test better ways to address challenges.

“Empowerment is at the heart of what we do, and today is about empowering Aboriginal and Torres Strait Islander Peoples by giving their eye health an ambitious way forward,” Mr Wishart said.

See the Indigenous Australia Program Five Year Country Strategy here: [link]

For more resources, including The Foundation’s Spring Appeal video featuring Sally from Katherine, see: https://www.hollows.org/au/spring-appeal

Highlights of the new Indigenous Australia Program Five Year Country Strategy:

The Fred Hollows Foundation’s new Indigenous Australia Program Five Year Country Strategy is underpinned by five goals and five objectives.

Our initiatives align with the Strong Eyes, Strong Communities plan for Aboriginal and Torres Strait Islander eye health, developed by members of Vision 2020 Australia.

Goals

  • Goal 1: Effective cataract treatment is accessible to all Aboriginal and Torres Strait Islander Peoples.
  • Goal 2: Trachoma, the world’s leading infectious cause of blindness, is eliminated from Australia.
  • Goal 3: Effective refractive error prevention and treatment is accessible to all Aboriginal and Torres Strait Islander Peoples.
  • Goal 4: Effective and timely treatment for diabetic retinopathy and other eye conditions is accessible to all Aboriginal and Torres Strait Islander Peoples.

Objectives

  • Strengthen regional eye health services.
  • Train and strengthen the eye health workforce.
  • Strengthen eye care in Aboriginal Community Controlled Health Services.
  • Finally eliminate trachoma.
  • Ensure governments adopt The Strong Eyes, Strong communities

Extra Resources and Save a date Webinar from Healthinfonet

The Australian Indigenous HealthInfoNet, in collaboration with The Fred Hollows Foundation, has launched a series of knowledge exchange tools about eye screening and care.

These new resources provide a broad overview of the screening services available for eye health and outline the roles of various professionals such as regional eye health coordinators, optometrists and ophthalmologists.

Each product has been designed as a useful tool for health workers and practitioners working with Aboriginal and Torres Strait Islander people, to assist in understanding the eye care journey.

This series of knowledge exchange products includes:

  • fact sheet for a comprehensive summary of eye screening and care (four pages)
  • an in brief fact sheet for quick, easy-to-digest bites of information (one page)
  • a short animated video offering educational information in an audio-visual format.

To complement the release of these eye health resources, the Australian Indigenous HealthInfoNet and The Fred Hollows Foundation will host a webinar featuring a special guest presenter Dr. Kristopher Rallah-Baker, Australia’s first Indigenous ophthalmologist.

The webinar, titled ‘Eye screening and care: treatment pathways and professional roles along that pathway’, will take place on at 12:00pm AEST on Wednesday 25 September 2019 and will include a Q & A session with Dr Rallah-Baker.

Participants are invited to register their interest prior to the event with the webinar organiser

Webinar Organiser
Tamara Swann
Australian Indigenous HealthInfoNet
Ph: (08) 6304 6158
Email: t.swann@ecu.edu.au

NACCHO #VoteACCHO Aboriginal Health #Election2019 @billshortenmp and @SenatorDodson set to unveil a $115 million #Labor plan to tackle the Indigenous health crisis today in Darwin : Including $ for @DeadlyChoices #SuicidePrevention  #MentalHealth #RHD #SexualHealth #EyeHealth

“Labor believes innovative and culturally appropriate health care models are central to improving the health outcomes of First Australians and closing the gap, noting that improving Indigenous health was “critical to our journey towards reconciliation. Labor would be funding programs “co-designed with and led by First Nations peoples – driven by the Aboriginal health workforce “

The Opposition Leader, who is also Labor’s spokesman for Indigenous affairs, will unveil the commitment while on the campaign trail with his assistant spokesman Senator Pat Dodson in the Northern Territory today;

Summary of the Labor Party $115 million commitments against NACCHO #VoteACCHO Recommendations

See all 10 NACCHO #VoteACCHO Recommendations Here

Refer NACCHO Recommendation 4

$29.6 million to improve mental health and prevent youth suicide : to administer the mental health funds through Aboriginal Community Controlled Health Services

See our NACCHO Chair Press Release yesterday

Refer NACCHO Recommendation 6

Sexual health promotion would get a $20 million boost

$13 million would be invested to tackle preventable eye diseases and blindness.

$3 million in seed funding provided to Aboriginal Medical Services to develop health and justice programs addressing the link between incarceration and poor health

Deadly Choices campaign would get $16.5 million for advertising to raise awareness of health and lifestyle choices

Refer NACCHO Recommendation 3

$33 million to address rheumatic heart disease

Media report from

‘Critical to reconciliation’: Labor’s plan to close the gap on Indigenous health

Bill Shorten is set to unveil a $115 million plan to tackle the Indigenous health crisis, as he seeks to position Labor as the only party capable of closing the ten-year gap in life expectancy between Aboriginal and Torres Strait Islander Australians and their non-Indigenous peers.

The package includes $29.6 million to improve mental health and prevent youth suicide, which has rocked communities in remote areas including the Kimberley where a spate of deaths has been linked to intergenerational trauma, violence and poverty.

The Opposition Leader, who is also Labor’s spokesman for Indigenous affairs, will unveil the commitment while on the campaign trail with his assistant spokesman Senator Pat Dodson in the Northern Territory on Thursday.

“Labor believes innovative and culturally appropriate health care models are central to improving the health outcomes of First Australians and closing the gap,” Mr Shorten said, noting that improving Indigenous health was “critical to our journey towards reconciliation”.

Labor’s package is $10 million more than the $19.6 million Prime Minister Scott Morrison announced for Indigenous suicide prevention on Saturday, after the suicide of an 18-year-old girl from the Kimberley last week.

Indigenous health advocates have previously raised concerns that the Coalition’s wider mental health package could be consumed by “mainstream” services like Headspace.

Mr Shorten highlighted Labor would be funding programs “co-designed with and led by First Nations peoples – driven by the Aboriginal health workforce”.

The Labor plan is to administer the mental health funds through Aboriginal Community Controlled Health Services, which employ teams of paediatricians, child psychologists, social workers, mental health nurses and Aboriginal health practitioners in vulnerable communities.

Official statistics show a ten-year gap in life expectancy between Indigenous and non-Indigenous Australians, with the rate of preventable hospital admissions and deaths three times higher for Aboriginal and Torres Strait Islander people.

Labor’s Indigenous health plan, which would be delivered over four years, also includes $33 million to address rheumatic heart disease, a preventable cause of heart failure, death and disability which is common in Aboriginal and Torres Strait Islander people.

Sexual health promotion would get a $20 million boost, while $13 million would be invested to tackle preventable eye diseases and blindness.

The Deadly Choices campaign would get $16.5 million for advertising to raise awareness of health and lifestyle choices and $3 million in seed funding provided to Aboriginal Medical Services to develop health and justice programs addressing the link between incarceration and poor health.

Mr Shorten said Labor would reinstate the National Aboriginal and Torres Strait Islander Health Equality Council, abolished by the Abbott Government in 2014.

Crisis support can be found at Lifeline: (13 11 14 and lifeline.org.au), the Suicide Call Back Service (1300 659 467 and suicidecallbackservice.org.au) and beyondblue (1300 224 636 and beyondblue.org.au) Or 1 of 302 ACCHO Clinics 

NACCHO Aboriginal Eye Health #CloseTheGap : @Vision2020Aus Launches #Strongeyesstrongcommunities – A five year plan for Aboriginal and Torres Strait Islander eye health and vision, 2019-2024 : With 24 recommendations to guide implementation

“ 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.”

Now is the time for 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.

That commitment, coupled with additional funding of $85.5 million over 5 years, will change the lives of many Aboriginal and Torres Strait Islander people, their families and their communities.

We look forward to working together to achieve a world class system that delivers culturally safe eye care to all Aboriginal and Torres Strait Islander people.”

Vision 2020 Australia CEO Judith Abbott:

The Vision 2020 Australia Aboriginal and Torres Strait Islander Committee have been advocating for change in Aboriginal and Torres Strait Islander eye health and vision care and should be proud of their work in the formation of the Strong Eyes, Strong Communities report.”

As recommended in the report, embedding eye health and vision care into Aboriginal

Community Controlled Organisations will help ensure the eye needs of Aboriginal and Torres  Strait Islander peoples are met and the gap in vision loss and blindness is closed.

National Aboriginal Community Controlled Health Organisation (NACCHO) Deputy CEO Dawn Casey:

Read Over 50 NACCHO Aboriginal Eye Health articles published in past 7 years

Vision 2020 Australia, the peak body for the eye sector, is calling for action to ensure that Aboriginal and Torres Strait Islander People have the same access to eye care as other Australians.

The newly released Strong eyes, strong communities – A five year plan for Aboriginal and Torres Strait Islander eye health and vision, 2019-2024 sets out a plan to achieve this goal.

Download the 55 Page The Five Year Plan 2019 – 2024 and Summary 24 Recommendations 

CLICK HERE for NACCHO Resources 

Most vision loss can be avoided or prevented through early identification and treatment, but Aboriginal and Torres Strait Islander people experience three times the rate of blindness and vision loss than non-Indigenous Australians and often wait much longer for treatment.

For example, Aboriginal and Torres Strait Islander people are currently waiting 63% longer on average for cataract surgery than non-Indigenous Australians.

Strong Eyes, strong communities describes what needs to be done to close this gap for vision and ensure eye problems in Aboriginal and Torres Strait Islander people are prevented wherever possible and treated early if they do develop.

Vision 2020 Australia has made 24 recommendations to implement the plan, which will require new funding of $85.5 million over the coming five years.

This funding will deliver more eye care services and glasses for Aboriginal and Torres Strait Islander people, support them to access the care they need and support the elimination of trachoma by 2020.

Vision 2020 Australia is also recommending other actions to improve overall planning and local pathways, strengthen the role of local community controlled services and increase access to specialist treatment

Key stats on Aboriginal and Torres Strait Islander People’s eye health

  • 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 is at risk of 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.

 

 

NACCHO Aboriginal Eye Health and #Housing @2019wihc #CloseTheGap : Co Host John Paterson CEO @AMSANTaus opening speech @IEHU_UniMelb #ClosingtheGap in Vision 2020 #CTGV19 Conference Plus #AliceSprings Declaration @OptometryAus @RANZCOeyedoctor @Vision2020Aus

Regarding the environmental improvements, we know that the NT Aboriginal population has the worst housing in Australia.  

Around 60% of Aboriginal people live in over-crowded housing and one third live in poorly maintained houses. 

This directly impacts on the ability of our people to maintain healthy living practices such as ensuing their kids have clean faces and clean clothes. 

We cannot keep on relying on antibiotics to get rid of trachoma – to be sustainable, there must be major improvements in environmental health and housing.

Improving housing will also lead to improvements in other infectious diseases that are way too common in our people in the NT

John Paterson CEO of the Aboriginal Medical Services Alliance of the NT or AMSANT. See full Speech Part 1 Below

Alice Springs Declaration

At the 2019 Close the Gap in vision 2020 conference, held in Alice springs, delegates heard that improvements in environmental health and housing are essential to eliminate trachoma and to reduce rates of other childhood infections that can lead to serious conditions such as rheumatic heart disease, blindness and deafness.

The conference heard about good progress in reducing trachoma rates but also that there had been some stalling in remote Central Australian communities where trachoma remains endemic and will not be eliminated unless housing is addressed.

Over half of Aboriginal people in the NT live in overcrowded housing and nearly one third live in poorly maintained housing. This is by far the worst result of any jurisdiction in Australia.

The Conference noted that there is currently a political impasse between the Commonwealth and Northern Territory governments which is preventing the completion of an agreement to enable desperately needed Commonwealth investment in Aboriginal housing to be made available.

The Conference was also concerned at the very slow pace of implementation of the Northern Territory government funded housing program, where only 62 million of 220 million has been spent in the first two years.

The delegates demand that both levels of government urgently work to fix this impasse to ensure that Aboriginal housing investment can be made available to address the critical housing needs in the NT and contribute to improving the health and wellbeing of Aboriginal Territorians.

This declaration was unanimously endorsed

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CTG19 ALICE SPRINGS DECLARATION

” Supporting and improving the local primary health care service capacity to confidently perform eye assessments should reduce the dependency on visiting eye specialists.

Going forward I see the promotion of these items as a highly effective way of investing in people and communities to have the capacity to manage and improve their own health outcomes.

Building local workforces must be key and I know that’s easier said than done.

The Roadmap to Close the Gap for Vision is a standout example of a program that has been successful in its impact towards closing the First Nations health gap.

Remarkable results have been achieved in just under a decade and the Roadmap recommendations are well on the way to being fully implemented.

Progress in Indigenous eye health has long been a challenge, making the success of this collaborative work even more remarkable.

The Hon Warren Snowdon Opposition Spokesperson Indigenous Health Keynote Address #CTG19 see full speech part 2 Below

Good morning everyone. My name is John Paterson and I am the CEO of the Aboriginal Medical Services Alliance of the NT or AMSANT. As many of you will know, AMSANT is the peak body for Aboriginal community controlled health services in the Northern Territory.

I’d like to begin by acknowledging the traditional owners, the Arrernte past, present and future, of the land on which we’re meeting: Mbantua – also known as Alice Springs.

To everyone here today, welcome to this important conference that is for the first time being held outside of Melbourne.

It will provide us with a great opportunity to share challenges, learnings and new ideas in a key regional centre for Aboriginal Australians who live in remote and very remote settings.  Aboriginal culture is strong and proud here, as it is across the NT.

Welcome to the many attendees from the NT and right across Australia. Thank you for the work you do in eye health and your interest in improving Aboriginal health outcomes.

I would like to begin by talking a little about the history of our sector in the NT.

It is a story of self-determination.

And it is a story about the passion and dedication in developing essential primary health care services to our people from the ground up.

It is a story about always being a strong advocate for our people.

Our sector provides comprehensive primary health care from Darwin to the most remote areas of the NT.

Central Australian Aboriginal Congress is 45 years old and is the second oldest ACCHS after Redfern. It is also the largest ACCHS in the NT and one of the largest in Australia.

Keynote from Donna Ah Chee CEO Congress calling on the sector to see Aboriginal and Torres Strait Islander eye health in the context of the bigger picture of Indigenous health.

Miwatj is the largest remote ACCHS in Australia and Utopia is the oldest ACCHS based in a very remote region, having also recently turned 40.

We have in total 26 members – 13 of which provide comprehensive primary health care across the NT.

We work in partnership with the Northern Territory Government, who also provide Aboriginal PHC services to the NT. However, ACCHSs are the larger of the two providers and our sector is expanding in line with the Commonwealth and NT Government commitment to transition PHC services to community control.

The theme of this conference – “Strengthen and sustain” – resonates with the foundational principles of our sector including the need to build capacity and self-determination.

The ACCHS sector aims to provide comprehensive primary health care with our larger services providing a broad and expanding range of services that go beyond providing physical health care. Comprehensive primary health care includes Social and Emotional Wellbeing, social support, youth work, health promotion and prevention, with some now extending into aged care and even disability care.

The broad range of services considered to be part of primary health care is in line with the Alma Ata Declaration of 1978, where primary health care leaders from around the world – including leaders from the Aboriginal community controlled sector – set out a vision of primary health care that is now reflected in how our sector operates.

The declaration emphasised the need for communities to have a say and be involved in the running of primary health care, hence the fundamental importance we attach to our sector being community controlled.

Another principle of the Declaration is that comprehensive primary health care should work with government policy makers and other sectors such as employment and housing, to address the conditions that lead to poor health. Our sector strives to do this at every level, from the community to national levels, and even on the international stage.

In the NT, one of the main ways we are achieving this is by working with other Aboriginal peak bodies in an Alliance called the Aboriginal Peak Organisation NT, or APONT. APONT includes AMSANT, along with the Central and Northern Land Councils, who assist traditional owners and native title holders in the management and development of their land, including through Aboriginal ranger groups and increasingly, community development projects.

The Alma Ata declaration also emphasised the need to aim for equity of outcomes in health care provision – noting that across the world including in rich countries such as Australia, there is an unacceptable health gap between the well off and those living in poverty. As you all know, on our own country, this health gap is even larger between Aboriginal Australians and the rest of Australia. Equity is a foundational principle of our sector.

The first national Aboriginal Health Strategy, in 1989, reflected these principles and others including the need to take a holistic view of health care, including the physical, social, spiritual and emotional health of people.

This strategy recognised the inter-relationship between good health and the social determinants of health and the need to partner with sectors outside health. The strategy also emphasised capacity-building of community-controlled organisations and the community itself to support local and regional solutions to improving health.

This was a fine strategy, however, an implementation plan was not properly developed and the strategy was not properly funded. This has been a recurring story in Aboriginal health over the years.

The most recent national Aboriginal health plan is also based on self-determination, including the need for community control and the critical importance of the social and cultural determinants of health.

As I hope most of you know, there are a national set of Close the Gap targets that are soon due to expire, that guide our efforts to improve Aboriginal health.  Sadly only 3 of the 8 target are currently on track – and the health gap is one of those that is not on track.

In fact, despite marked improvement in life expectancy in the NT over the last thirty years, life expectancy in the NT now seems to be stalling which is due to the failure to address social determinants, and the ever-growing chronic disease epidemic in our people.

I believe we would have seen much more progress towards closing the gap if the vision first set out in 1989 in the National Aboriginal Health Strategy had been implemented by both the Federal and State governments, including the critical need to commit to self-determination.

While that precious opportunity has foundered for the last three decades, I believe we are once again at a critical juncture and seeing a shift towards governments working in equal partnership with our people. This trend must continue if we are to see sustainable improvement.

At a national level, I am very heartened to see that the process to refresh the Closing the Gap targets is now developing into an equal partnership between Aboriginal leaders across Australia and Commonwealth, State and Territory governments through the Council of Australian Governments or COAG process.

We now, for the very first time, have a large group of Aboriginal peak bodies working closely with government to set the forward agenda for tackling the health gap. Our national peak organisation, NACCHO, led by an inspiring Aboriginal Alice Springs leader – Pat Turner – is at the vanguard of this work.

Read all 50 plus NACCHO Aboriginal Eye Health Articles Here

I represent APONT on this national coalition, ensuring that our leadership in the Northern Territory continues to influence the national agenda. We will be working hard to ensure that the targets reflect the critical issues affecting the health of our people – across the social determinants, and including issues such as housing,  the skyrocketing imprisonment rates and tragically high rates of children in the child protection system.

How does all of this high-level government policy relate to eye care?

We know that our Aboriginal community controlled health services in the NT are under resourced.

Six years ago, a study was done in a small ACCHS in the NT – one of our better funded services. The study looked at how much it cost to carry out all the chronic disease care recommended by the CARPA manual – which is the guideline that all our services use.

It found that the service was under funded to the tune of $1700 per person per year. This funding gap may have increased since then.  The AMA has recently reiterated that there is a large funding gap in Aboriginal primary health care.

We cannot build specialist services, including specialist eye services, on a foundation of an under-resourced primary health care sector.  Our sector must be properly funded.

Trachoma is often described as a disease of poverty, which is one of the reasons why its continued existence in Australia, and almost exclusively in Aboriginal communities, is a national disgrace.

The World Health Organisation has developed the SAFE strategy for eliminating trachoma.

I am sure most of you know that the S stands for surgery, A for antibiotics, F for facial cleanliness and E for Environmental Improvements.

Regarding the environmental improvements, we know that the NT Aboriginal population has the worst housing in Australia.

Around 60% of Aboriginal people live in over-crowded housing and one third live in poorly maintained houses.

This directly impacts on the ability of our people to maintain healthy living practices such as ensuing their kids have clean faces and clean clothes.

We cannot keep on relying on antibiotics to get rid of trachoma – to be sustainable, there must be major improvements in environmental health and housing.

Improving housing will also lead to improvements in other infectious diseases that are way too common in our people in the NT, including skin sores and sore throats – which can both precipitate RHD; and with skin sores also being linked to high rates of renal disease.

A recent data linkage study found that over-crowded housing was by far the biggest reason for children missing school – accounting for over 30 days of missed school a year on average.

We know that poor school attendance is very closely linked to poor school results.  Our children need decent living conditions if they are to thrive both physically but also socially and at school.

What is AMSANT doing about the shocking state of housing in the NT?

AMSANT has worked as part of the APONT alliance in supporting the formation of an Aboriginal Housing committee, AHNT, and is supporting AHNT to become the recognised Aboriginal housing peak body for the NT. Along with AHNT, we are working closely with NT Department of Housing to develop a community led housing strategy, to return Aboriginal housing to community control.

More info Register 

This is a long journey – but it is already bearing some fruit.

However, currently, as many of you will be aware from recent media reports – the NT and Commonwealth are at a stand-off about desperately needed Commonwealth funding for remote Aboriginal housing.

We must have cooperation between the two levels of government to address our housing crisis. We are tired of the excuses and political stand offs, while our communities suffer.

If they would for one moment stop and listen to us, come and talk with us, they would hear our message loud and clear – we want a seat at the decision-making table.

It the Prime Minister and the State and Territory Premiers and Chief Ministers can agree on an equal partnership with Aboriginal peak bodies on Closing the Gap, then the Commonwealth and NT governments can do the same for Aboriginal housing. We say – make it happen!

And now to eyes.

 

Eye health matters. In Australia, people with even mild vision loss have a risk of dying that is 2.6 times higher than those with good vision.

Vision loss causes 11% of the Indigenous health gap, meaning it accounts for 11% of years of life lost to disability for Indigenous people. It is the third leading cause of the gap behind cardiovascular disease and diabetes.

The 2008 National Indigenous Eye Health Strategy demonstrated the huge gap between the eye health of Indigenous and other Australians:

  • Indigenous adults were 6 times more likely to become blind as non-Indigenous, despite 94% of this vision loss being preventable or treatable;
  • Australia was the only developed country in the world to have endemic trachoma in some regions;
  • And yet studies showed that Indigenous children have better eyesight than others.

However, as you know, a lot is happening in the eye space and primary health care is a critical part of that work.

The work done to close the gap for vision has been very successful. The progress made on the Roadmap to Close the Gap for Vision, which comprises action against over 40 recommendations, is substantial and impressive, particularly given the number of stakeholders in many sectors who have contributed to its achievements.

One of the achievements in the NT has been the formation and ongoing success of regional eye health coordination groups, which are collaborations and partnerships involving all the key eye health stakeholders including primary health care, and are an important component of the Roadmap to Close the Gap for Vision.

The Central Australian and Barkly collaboration has been working effectively for 10 years now, and has been joined in recent years by a Top End collaboration.

AMSANT is involved in both groups and has been funded by the Fred Hollows Foundation to become more involved, including through a position supporting the Central Australian committee.

However, I hope that you have got the message that everyone in health care – including those in eye health care – need to think more broadly about health and not just focus on their part of the gap.

The Aboriginal vision of health is holistic and specialist services need to be built on a strong primary health care foundation.

The international health research has shown that health systems built on a strong primary health care foundation are more equitable affordable and sustainable.

I believe that the eye care gap will not sustainably close – along with the rest of the health gap – if we do not have political commitment to self-determination, and an equitable approach to funding Aboriginal primary health care, based on need.

And we also  need a commitment to fixing the social determinants of health, equitably, based on need and Aboriginal-led.

We must avoid the situation where specialist areas advocate separately to government for their bit of Aboriginal health funding without seeing the bigger picture and the lack of resources on the ground in primary health care.

We need to work together in true partnership if we are to close the gap and that means we MUST be at the decision-making table, not an afterthought.

So thank you for all the work that you do in eye health care- we do appreciate it.

And I hope that you enjoy the two days and go back to your work refreshed, invigorated and inspired.

Thank you.

Part 2 : ADDRESS TO THE CLOSE THE GAP FOR VISION BY 2020

From the outset I want to stress that Federal Labor is acutely aware that Australia remains the only developed country with endemic trachoma, which is only found in our Aboriginal and Torres Strait Islander communities.

Further, while we acknowledge the scourge of Trachoma, 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. We have seen inroads in the rates of trachoma, many thanks to people in this room.

Trachoma has dropped from 21 per cent in outback children in 2008 to 3.8 per cent in 2018 and is on track to be eliminated by the end of 2020. This is a marvellous achievement and I again want to thank the tireless effort, tenacity and dedication of those in this room over the last decade in ensuring this has remained a front and centre issue for consecutive governments across partisan lines.

Today I want to discuss three things:

  • Where to now and looking beyond 2020
  • How we can build on the success of the Roadmap in other spaces and;
  • What to expect from a Shorten Labor Government

As the incidence of Trachoma lessens and is likely to be completely eliminated come 2020/21, we will face different vision-loss challenges. Blindness and impaired vision among Aboriginal people was six times the national rate in 2008, and it is now down to three times the national rate. However, Aboriginal and Torres Strait Islander Australians are still most likely to experience permanent vision impairment, with most cases of avoidable blindness resulting from uncorrected refractive error, diabetic retinopathy and cataracts.

One in 10 Aboriginal and Torres Strait Islander adults is at risk of Diabetic Retinopathy, which we all know can lead to irreversible vision loss. 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.

And I want to note here, that I welcomed Minister Wyatt’s announcement in August last year to commit $2 million to provide Aboriginal and Torres Strait Islander people with easier access to affordable prescription glasses. This was a positive first step.

The case for well-informed advocacy around uncorrected refractive error, diabetic retinopathy and cataracts in the First Nation population must be a priority for this sector come 2020 and beyond. As we edge towards the complete elimination of Trachoma the traction from governments’ and the funding which comes attached I anticipate will lessen. This will be no surprise to people in this room.

Security of funding will decline without ongoing strategic advocacy from the sector. There will need to a be a sustained and coordinated approach as there has been with the Roadmap to ensure this doesn’t curtail the inroads that are being made in other areas of vision loss. For example; Aboriginal and Torres Strait Islander Australians with diabetes have significantly fewer recommended eye checks than the non-indigenous Australian population and this incidence is particularly escalated in remote and regional areas [35% comparted with 64% respectively].

The total indirect cost of blindness as a result of diabetic retinopathy and diabetic macular oedema, the most frequent manifestations of diabetic retinopathy, is estimated to be more than $28,000 per person. Early investment into coordinated primary healthcare presents a powerful fiscal argument for governments at all levels.

These are the sorts of messages I encourage the sector to advocate for, we are in fiscally uncertain times so governments are constantly looking for costefficient measures.  The fact the up to 98 per cent of diabetes-related blindness can be prevented through annual eye exams and timely treatment in the early stages of disease, is compelling.

Investing in professional development and training to enhance existing clinicians’ skills to perform eye-health assessments can produce significant savings for both the patient and the tax payer. I am a proponent of the MBS 715 item [Aboriginal Health Check] and the annual MBS 12325 item [Diabetic Retinopathy Screening] to be employed in all instances, as both schedule items promote early screening and diagnosis, preventing future complications and the costs associated with vison impairment.

The establishment of diabetic eye screening rates as a key performance indicator for Primary Health Networks is a sensible way to drive MBS revenue and improve eye health outcomes. Further, employing MBS item service delivery models, is a sustainable model of care which does not rely on ongoing or recurrent government funding. Increased information-sharing around the schedule benefits can produce significant preventative health gains to the target communities as well as provide large fiscal returns to service practices.  It’s a no brainer.

Further, supporting and improving the local primary health care service capacity to confidently perform eye assessments should reduce the dependency on visiting eye specialists. Going forward I see the promotion of these items as a highly effective way of investing in people and communities to have the capacity to manage and improve their own health outcomes.

Building local workforces must be key and I know that’s easier said than done.

The Roadmap to Close the Gap for Vision is a standout example of a program that has been successful in its impact towards closing the First Nations health gap. Remarkable results have been achieved in just under a decade and the Roadmap recommendations are well on the way to being fully implemented. Progress in Indigenous eye health has long been a challenge, making the success of this collaborative work even more remarkable. This work has undergone rigorous scientific process and has a strong evidence base.

Importantly it has been strongly supported by local communities and organisations, including leading peak bodies and philanthropic organisations.

This disciplined coordination is what I think other sectors can really look towards and aspire to. And I must say this discipline is attributed in major part to the work of Professor Taylor. Stopping trachoma and other infections through the promotion of good hygiene practices and the emphasis on health hardware are pathways to negate further chronic health conditions.

Including: Ear infections and otitis media

  • Respiratory infection
  • Tooth and gum disease
  • Skin infections
  • Kidney disease

And I think most markedly

  • Rheumatic Heart Disease

The Roadmap has been able to achieve comprehensive culturally safe coordination in navigating all levels of care which is critical when managing health conditions, such as avoidable blindness.  Skilled workforce shortage complications in regional areas can ultimately be ameliorated by investing in people and communities to have the capacity to manage and improve their own health outcomes.

I know Diabetic retinopathy cameras and trained operators are being placed in more than 150 Aboriginal health clinics across Australia and this ideally must be the model we aspire for in other complex health areas. This model has been promoted and driven throughout the Roadmap.

To reiterate my major point, Labor is committed to Closing the Gap in eye health. The Roadmap was established under Labor and has since made significant improvements to the eye health of First Australians, as I’ve acknowledged. A Shorten Labor Government is committed to fully implementing the Roadmap to Close the Gap for vision.

A Shorten Labor government appreciates there is still work to be done to close the gap to meet the 2020 deadline. As an outcome of the Roadmap there are many regions of Australia where successful eye care programs have been developed providing high quality eye care for First Australians.

We acknowledge these successes and aim to build on and enhance these existing services. Now is the time to consolidate this good work and finally end avoidable blindness to ensure we meet our World Health Organisation obligations and successfully eliminate Trachoma. As Professor Taylor says, “we can’t afford to take our foot off the accelerator.” Equitable access to specialist and general eye health care services is critical to reducing high rates of preventable blindness among Aboriginal and Torres Strait Islander people.

We’ve seen too many cases of good work in Aboriginal affairs left unevaluated and subsequently dismantled, especially under the Abbott/Turnbull/ Morrison government. The Tackling Indigenous Smoking program is a case in point which we’ve witnessed under this Government.

Guiding all the decisions under a Shorten Labor Government will be evidence- based policy.  The Federal Labor team will certainly have more to say on this and you can expect further announcements in the coming months in the lead up to the election. But I can say that any further investments will be to meet the 2020 Roadmap.

Under a Shorten Labor government we will be prioritising:

  • The national implementation of regional coordinators
  • Population based funding of outreach services
  • Case management and local coordination
  • Prompt housing repair and maintenance to ensure First Australians have access to safe and functioning bathrooms

We’re at the pointy end of finalising our election commitments but I do want to use this opportunity to encourage the experts before me to bring forward any policy proposals you have. If anyone wishes to share any policy ideas, as some have already, by all means I am open to hearing them and sharing them with my Federal Labor team. And for anyone in this room who isn’t aware I have an open-door policy, so please don’t hesitate to get in touch in near future.

I think that’s enough from me.

Thank you for your time this morning.