NACCHO Aboriginal Health and #TopEndFASD18 : “Let’s Make #FASD History” says Top End Foetal Alcohol Spectrum Disorder (FASD) forum with 6 key messages to be taken into account addressing FASD:

 ” The forum delegates agreed that there was an urgent need for action to prevent FASD in our Top End communities, and across the Northern Territory.

It is essential that our responses do not stigmatise women or Aboriginal people.

It is important that we don’t lay blame, but instead work together, to support our women and young girls.

Everyone is at risk of FASD, so everyone must be informed the harmful effects of drinking while pregnant.

Our men also need to step up and support our mothers, sisters, nieces and partners, to ensure that we give every child the best chance in life.”

A landmark Top End Foetal Alcohol Spectrum Disorder (FASD) forum* was held in Darwin on 30-31 May 2018

Read over 25 NACCHO Aboriginal Health and FASD articles published over 6 years

“ Territorians want and deserve access to high quality health services,” Ms Fyles said.

Alcohol abuse impacts on individuals, families, businesses and our community in many different ways, including the risk of causing permanent and irreversible damage to a baby if alcohol is consumed during pregnancy.

That’s why reducing alcohol related harm is a key priority of the Territory Labor Government.

Our Government will develop a whole of government framework to prevent FASD with universal and targeted strategies to address FASD “

Minister for Health, Natasha Fyles, today welcomed 180 delegates to the inaugural Top End Foetal Alcohol Spectrum Disorder Forum in Darwin see Ministers Press Release Part 2 below

#TopEndFASD18  Bringing together Aboriginal leaders, FASD experts, Aboriginal community-controlled organisations, government representatives, medical professionals, and Non-Government organisations. Approximately 180 delegates representing 37 organisations across the Northern Territory.

FASD is often considered to be a ‘hidden’ disability, because more often than not, the physical characteristics of the individual are not easily recognised. Instead, an individual may present with learning and behavioural difficulties, which may present for a range of disorders.

As a result, FASD is not easily identified and individuals can go undiagnosed and receive inadequate treatment and support.

The forum heard from the NT Minister for Health and the Attorney General Natasha Fyles, NT Children’s Commissioner, Colleen Gwynne, Professor Elizabeth Elliott, Dr James Fitzpatrick, NOFASD and FASD Hub.

The forum also heard from Aboriginal community controlled organisations Danila Dilba, Wurli Wurlinjang, Anyinginyi Health Services, Aboriginal Medical Services Alliance Northern Territory and the North Australian Aboriginal Justice Agency.

Over two days, the forum delegates discussed the impacts of FASD on individuals, families and communities and acknowledged that alcohol misuse and its consequences are an issue for all Territorians, particularly our most vulnerable. Delegates also heard the evidence on how the prevalence of FASD impacts many of our services, including health, education and justice. Delegates learnt that trauma runs deep, and healing and making the right connections is crucial.

The delegates raised the following key messages to be taken into account in addressing FASD:

 1.Prevention and raising awareness

FASD is entirely preventable, much of its impacts are also irreversible. The harms caused by alcohol in our communities are not acceptable and we will all work together to develop prevention and intervention strategies that are culturally appropriate and relevant for our 2

people and communities. It is acknowledged that current and proposed alcohol control measures in the NT are a critical component of prevention.

2. Collaborative Approaches

The forum identified an urgent need for Aboriginal organisations, government agencies, NGOs and local communities to work together to develop policies and programs for women, men, children and communities in the Top End communities and to contribute to the development of an NT FASD Strategy. This needs to be Aboriginal community-led by the health, education, justice and child protection sectors.

 3.Access to FASD resources

It was evident that there is a need for more investment in developing culturally appropriate tools and resources for local Aboriginal communities and key stakeholders working on the frontline and also at the strategic level.

4.Assessment and Treatment services

An identified priority need is for the establishment of multi-disciplinary neuro-developmental assessment and treatment services that are strategically linked with existing service settings, including primary health care, education, child protection and the justice system.

5.Support for children and families

Research is needed to better understand how best to support children and families with FASD and other related issues that also often affect families, such as trauma. We refer to the Fitzroy Valley as a best practice model, as many strong women and leaders in the community worked in partnership with FASD experts and research institutes.

6.Workforce

The skilling and expansion of the workforce needed for prevention, assessment and treatment of FASD, particularly the community based remote Aboriginal workforce, was identified as an important need.

From this forum, we have heard the experiences about the high levels of despair and sense of disempowerment and hurt of our people and these are sad stories. We were also enlightened by the enthusiasm, dedication, passion and hope from local communities, all professions and services, that want to do more and can do more to make FASD History!

*APO NT will be producing a full report on the outcomes of the FASD Forum over the coming weeks.

Generational Change: Putting the spotlight on Foetal Alcohol Spectrum Disorder

30 May 2018

Minister for Health, Natasha Fyles, today welcomed 180 delegates to the inaugural Top End Foetal Alcohol Spectrum Disorder Forum in Darwin.

“Territorians want and deserve access to high quality health services,” Ms Fyles said.

“Alcohol abuse impacts on individuals, families, businesses and our community in many different ways, including the risk of causing permanent and irreversible damage to a baby if alcohol is consumed during pregnancy.

“That’s why reducing alcohol related harm is a key priority of the Territory Labor Government.

“Our Government will develop a whole of government framework to prevent FASD with universal and targeted strategies to address FASD.

“This strategy was supported by recommendations in the recent Riley Review into Alcohol Policy and Legislation Alcohol Report and is now an important part of the Territory Labor Government’s Alcohol Harm Minimisation Action Plan to deliver sweeping alcohol reforms for generational change.”

The NT Department of Health funded the Aboriginal Peak Organisations NT (APONT) to deliver the 2 day forum.

The themes of the Forum are:

  • Increase knowledge and raise awareness about FASD in Top End communities and the impact of alcohol during pregnancy on the developing baby;
  • Understand the impact of FASD on children, youth and their families
  • Identify the challenges, issues and solutions for governments, service providers and other key stakeholders;
  • Identify culturally appropriate resources, tools and protocols
  • Establish a Top End FASD Network.

Minister Fyles said that Forum provides an important consultation opportunity with the health sector and community to feed into the development of the NT’s FASD Strategy, for release later this year.

“Stories will be shared and ideas and actions generated to inform the Strategy, which in turn will help guide communities and Government to work together in partnerships to prevent FASD,” Ms Fyles said.

“The NT FASD Strategy will promote the screening of alcohol use before and during pregnancy; appropriate multi-disciplinary assessment; early intervention, support and case management; and will develop targeted education campaigns for those who are most at risk from alcohol-related harms.

“This work is supported in our Government’s 10-Year Early Childhood Development Plan to lead cultural change in reducing alcohol consumption and harms in the community.

“Our whole of government approach to respond to FASD will be crucial to preventing this completely preventable lifelong and permanent condition.”

 

NACCHO Aboriginal Health and Teenage #Pregnancy #maternalMHmatters : Download @AIHW Report : Indigenous teenage mothers almost twice as likely to smoke during pregnancy as non-Indigenous mothers. @sistaquit #Prevention2018

 

” Indigenous teenage mothers are over-represented One in 4 (24%) teenage mothers identified as Aboriginal and/or Torres Strait Islander in 2015.

This means that Indigenous women were over-represented amongst teenage mothers, given Indigenous women aged 15–19 account for only 5.3% of the overall population of Australian females of the same age.

The proportion of Indigenous mothers in Australia is higher in Remote and Very remote areas, and teenage Indigenous mothers also follow this pattern

Compared to non-Indigenous teenage mothers, Indigenous teenage mothers were 1.5 times as likely to smoke in the first 20 weeks of pregnancy (43% compared with 28%) “

Read Part 2 Below or Download :

NACCHO Download aihw-per-93.pdf

Babies of teenage mothers are more likely to be premature and experience health issues in the first month than babies born to women just a few years older, a new report has revealed.

Teenage mums are also more likely to live in Australia’s lowest socio-economic areas (42 per cent) compared to mums aged 20-24 years (34 per cent), according to the report by the Australian Institute of Health and Welfare (AIHW).

The report, published today , showed the numbers of teenage mothers had dropped from 11800 in 2005 to 8200 in 2015, with nearly three-quarters of teenage mothers aged 18 or 19.

Compared to babies born to mothers aged 20-24 years, more babies born to teenage mothers were premature, had a low birth weight and needed admission to special care nursery.

Despite the negative outcomes for babies, the report showed positive trends for teenage mothers including more spontaneous labours, lower caesarean section rates and less diabetes for teenage mothers.

“The difference between teenage mothers and those in the slightly older age group is due in part to a large number of teenage mothers living in low socio-economic areas,” says AIHW report author Dr Fadwa Al-Yaman.

Dr Al-Yaman said the differences could also be due to the higher smoking rates in pregnancy, with a quarter of teenage mothers smoking after 20 weeks of pregnancy compared to 1 in six of those aged 20 to 24.

A quarter of teenage mothers identified as Aboriginal or Torres Strait Islander, with Indigenous teenage mothers almost twice as likely to smoke during pregnancy as non-Indigenous mothers.

Dr Al-Yaman said risk factors were highly interlinked, with issues such a smoking, low levels of education and employment being concentrated in remote areas.

The teenage birth rate in metro areas is less than half that of regional areas, she said.

“There is a strong link between socio-economic disadvantage and living in remote areas,” she told AAP.

“You need to have access to transport, access to health services and if you have to pay for your transport, sometimes over an hour’s worth, it’s going to take more of your welfare money.”

SISTAQUIT Trial Recruiting Services Now

The SISTAQUIT™ trial aims to improve health providers’ skills and when offering smoking cessation care to pregnant Aboriginal and Torres Strait Islander women.

Pregnancy is an important window of opportunity for GPs and health providers to help smokers quit, however they often lack the confidence and skills to address their patients’ smoking.

This intervention provides webinar-based training in evidence based and culturally competent smoking cessation care for providers working within Aboriginal Medical and Health Services.

The SISTAQUIT™ Team are currently recruiting Aboriginal Medical Services (AMS) and GP practices in NSW, WA, QLD, SA and NT for this study.

To find out more about your service being involved in the SISTAQUIT™ trial please contact Dr Gillian Gould or Joley Manton at the University of Newcastle.

Website

Download the trial brochure here

Download an information sheet here

Part 2 Indigenous Mothers

Indigenous teenage mothers are over-represented One in 4 (24%) teenage mothers identified as Aboriginal and/or Torres Strait Islander in 2015.

This means that Indigenous women were over-represented amongst teenage mothers, given Indigenous women aged 15–19 account for only 5.3% of the overall population of Australian females of the same age.

Indigenous mothers are younger than average

The average age of Indigenous teenage mothers (17.8 years) was lower than for non- Indigenous mothers (18.1 years). Indigenous teenage mothers were 4.5 times as likely to be aged under 15 (1.8%; 35) as non-Indigenous teenage mothers (0.4%; 27) and less likely to be aged 19 (37.4%; 744 compared with 49.1%; 3,048).

More likely to live in remote areas

The proportion of Indigenous mothers in Australia is higher in Remote and Very remote areas, and teenage Indigenous mothers also follow this pattern.

In 2015, the Indigenous population rate for 15–19 year old mothers living in Remote and Very remote areas was 84.9 per 1,000 females, which was 5.5 times the non-Indigenous rate (15.2 per 1,000).

The population rate for 15–19 year old Indigenous mothers was also higher for women living in Major cities at 40.7 per 1,000 for Indigenous women compared with 7.1 per 1,000 for non-Indigenous women.

Fewer and later antenatal visits

Indigenous teenage mothers generally attended fewer antenatal visits than non-Indigenous teenage mothers, with higher proportions of 1 visit (1.5% compared with 0.9%) and 2–4 visits (9.5% compared with 6.1%) and lower proportions of 5 or more visits (86% compared with 91%).

They were 1.1 times as likely to attend their first antenatal visit at 20 weeks gestation or more (25% compared with 23%).

More likely to smoke

Compared to non-Indigenous teenage mothers, Indigenous teenage mothers were:

• 1.5 times as likely to smoke in the first 20 weeks of pregnancy (43% compared with 28%)

• 1.7 times as likely to smoke after 20 weeks (36% compared with 21%).

Higher rates of diabetes

Indigenous teenage mothers were 1.2 times as likely as non-Indigenous teenage mothers to have diabetes (6.0% compared with 4.9%) and gestational diabetes (5.1% compared with 4.2%).

Onset of labour, method of birth and perineal status

In 2015, Indigenous teenage mothers were more likely than their non-Indigenous counterparts to have spontaneous labour (66% compared with 62%), and less likely to have induced labour (28% compared with 32%), but equally likely to have no labour (both 6.1%).

Compared to non-Indigenous teenage mothers, Indigenous teenage mothers were slightly more likely to:

• have a caesarean section (19% compared with 18%)

• have an intact perineum (27% compared with 26%).

 

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

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

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

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

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

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

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

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

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

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

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

 

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

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

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

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

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

Read full press release here

 

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

SEE NACCHO Response

SEE an Indigenous Patients Response

See Nurses PAQ Misleading and false campaign

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

Read full AMSANT press Release

Listen to interview with Donna Ah Chee

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

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

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

Read full Story HERE

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

Read Download Full Transcript

Senator Patrick Dodson

Download the report from HERE

Community Groups Call For Action on Indigenous Incarceration Rates

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

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

Read Press Release HEAR

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

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

Read Download the Press Release

TANGENTYERE WOMEN’S FAMILY SAFETY GROUP (FED

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

Read press releases and link to Download the National Guide

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

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

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

 

Part B Full Text The Australian Article Easter Monday

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Minister @KenWyattMP launches NACCHO @RACGP National guide for healthcare professionals to improve health of #Aboriginal and Torres Strait Islander patients

 

All of our 6000 staff in 145 member services in 305 health settings across Australia will have access to this new and update edition of the National Guide. It’s a comprehensive edition for our clinicians and support staff that updates them all with current medical practice.

“NACCHO is committed to quality healthcare for Aboriginal and Torres Strait Islander patients, and will work with all levels of government to ensure accessibility for all.”

NACCHO Chair John Singer said the updated National Guide would help governments improve health policy and lead initiatives that support Aboriginal and Torres Strait Islander people.

You can Download the Guide via this LINK

A/Prof Peter O’Mara, NACCHO Chair John Singer Minister Ken Wyatt & RACGP President Dr Bastian Seidel launch the National guide at Parliament house this morning

“Prevention is always better than cure. Already one of the most widely used clinical guidelines in Australia, this new edition includes critical information on lung cancer, Foetal Alcohol Spectrum Disorder and preventing child and family abuse and violence.

The National Guide maximises the opportunities at every clinic visit to prevent disease and to find it early.It will help increase vigilance over previously undiagnosed conditions, by promoting early intervention and by supporting broader social change to help individuals and families improve their wellbeing.”

Minister Ken Wyatt highlights what is new to the 3rd Edition of the National Guide-including FASD, lung cancer, young people lifecycle, family abuse & violence and supporting families to optimise child safety & wellbeing : Pic Lisa Whop SEE Full Press Release Part 2 Below

The Royal Australian College of General Practitioners (RACGP) and the National Aboriginal Community Controlled Health Organisation (NACCHO) have joined forces to produce a guide that aims to improve the level of healthcare currently being delivered to Aboriginal and Torres Strait Islander patients and close the gap.

Chair of RACGP Aboriginal and Torres Strait Islander Health Associate Professor Peter O’Mara said the third edition of the National guide to a preventive health assessment for Aboriginal and Torres Strait Islander people (the National Guide) is an important resource for all health professionals to deliver best practice healthcare to Aboriginal and Torres Strait Islander patients.

“The National Guide will support all healthcare providers, not just GPs, across Australia to improve prevention and early detection of disease and illness,” A/Prof O’Mara said.

“The prevention and early detection of disease and illness can improve people’s lives and increase their lifespans.

“The National Guide will support healthcare providers to feel more confident that they are looking for health issues in the right way.”

RACGP President Dr Bastian Seidel said the RACGP is committed to tackling the health disparities between Indigenous and non-Indigenous Australians.

“The National Guide plays a vital role in closing the gap in Aboriginal and Torres Strait Islander health disparity,” Dr Seidel said.

“Aboriginal and Torres Strait Islander people should have equal access to quality healthcare across Australia and the National guide is an essential part of ensuring these services are provided.

“GPs and other healthcare providers who implement the recommendations within the National Guide will play an integral role in reducing health disparity between Indigenous and non-Indigenous Australians, and ensuring culturally responsive and appropriate healthcare is always available.”

The updated third edition of the National Guide can be found on the RACGP website and the NACCHO website.

 

Free to download on the RACGP website and the NACCHO website:

http://www.racgp.org.au/national-guide/

and NACCHO

Part 2 Prevention and Early Diagnosis Focus for a Healthier Future

The critical role of preventive care and tackling the precursors of chronic disease is being boosted in the latest guide for health professionals working to close the gap in health equality for Indigenous Australians

The critical role of preventive care and tackling the precursors of chronic disease is being boosted in the latest guide for health professionals working to close the gap in health equality for Indigenous Australians.

Minister for Indigenous Health, Ken Wyatt AM, today launched the updated third edition of the National guide to a preventive health assessment for Aboriginal and Torres Strait Islander people.

“Prevention is always better than cure,” said Minister Wyatt. “Already one of the most widely used clinical guidelines in Australia, this new edition includes critical information on lung cancer, Foetal Alcohol Spectrum Disorder and preventing child and family abuse and violence.

“The National Guide maximises the opportunities at every clinic visit to prevent disease and to find it early.

“It will help increase vigilance over previously undiagnosed conditions, by promoting early intervention and by supporting broader social change to help individuals and families improve their wellbeing.”

The guide, which was first published in 2005, is a joint project between the National Aboriginal Community Controlled Health Organisation (NACCHO) and the Royal Australian College of General Practitioners RACGP).

“To give you some idea of the high regard in which it is held, the last edition was downloaded 645,000 times since its release in 2012,” said Minister Wyatt.

“The latest edition highlights the importance of individual, patient-centred care and has been developed to reflect local and regional needs.

“Integrating resources like the national guide across the whole health system plays a pivotal role in helping us meet our Closing the Gap targets.

“The Turnbull Government is committed to accelerating positive change and is investing in targeted activities that have delivered significant reductions in the burden of disease.

“Rates of heart disease, smoking and binge drinking are down. We are on track to achieve the child mortality target for 2018 and deaths associated with kidney and respiratory diseases have also reduced.”

The National Guide is funded under the Indigenous Australian’s Health Programme as part of a record $3.6 billion investment across four financial years.

The RACGP received $429,000 to review, update, publish and distribute the third edition, in hard copy and electronic formats.

The National Guide is available on the RACGP website or by contacting RACGP Aboriginal and Torres Strait Islander Health on 1800 000 251 or aboriginalhealth@racgp.org.au.

 

 

 

NACCHO Aboriginal Women’ Health #NWHS18 Read full Keynote Address Pat Turner CEO NACCHO @RANZCOG National Women’s Health Summit

RANZCOG National Women’s Health Summit

2 March 2018

Patricia Turner, CEO NACCHO

Keynote address “Aboriginal and Torres Strait Islander Women’s Health”

Read over 300 NACCHO Aboriginal Health Articles we have published over the past 6 years : SUBSCRIBE HERE

 

I begin by paying my respects to members of the Gadigal of the Eora Nation as the traditional custodians of this place we now call Sydney.

It is proper that I acknowledge the different Aboriginal groups when I travel to various parts of Australia because it should never be forgotten that our people have lived here for over 65,000 years. In those days Australia was a truly liveable place for our people.

So, thank you very much for the warm welcome Julia and to RANZCOG for inviting me to speak today.

It was important to hear from Minister Hunt, to listen to Professor Baum articulate the social determinants of women’s health and Professor Gannon discuss the economic impact of women’s health.

It is an honour to be asked to address an audience of 100 successful and influential women from the health care sector.

Today this summit is an opportunity to highlight health challenges facing Aboriginal women today. To help them live healthier, longer lives, supported by better, more targeted health services across the nation.

But first, I think this morning is an opportunity for all of us in this place to celebrate the contribution women make in our lives.

It is important to acknowledge how far we have all come together over the last 100 years.

The new medical technology now saves countless lives, the testing regimens are first rate, surgical care has been enhanced and women now have pathways to a multitude of careers and thrive in the health workforce. Some are even in positions of ‘real power’ to advocate for reforms.

Now let’s be clear that Australia has a world-class health system, but not for all of us! Yes, I could mention issues around pay, promotion, mentoring, bullying and harassment but that’s not why we are here today! So, let’s focus today on the fact that health outcomes for Aboriginal and Torres Strait Islander women in Australia are a long way from those of non-Indigenous women.

Whilst it is very flattering to be counted as one of the 100 influential women in this room.

It is important that you know how I became the person I did. I know that my experience was gained from and influenced by my mother.

She was the first medical person I knew. She cared for me and my family as a healer and she helped make me the woman I am today. Education just knocked off my rough edges!

Now, let’s not forget that Aboriginal people invented Bush Medicine which they still use today. They had ready access to bush tucker and led a healthy way of life before colonisation. We still have remnants of our past practice that continue today like using traditional healers and have access to very advanced Western medical models of health care.

I have had a long, varied and distinguished career in the Australian Public Service including as Deputy Secretary of Prime Minister and Cabinet, Centrelink and was the longest serving CEO of ATSIC. I was also the inaugural CEO of the National Indigenous Television (NITV). So, I know how to argue for a change in women’s health policy. I’ve had a lot of experience in dealing across bureaucracy, Ministers, budget cycles, developing public health initiatives and campaigns and essentially dealing with governments at every level in this country.

Now, NACCHO is the national peak body representing 144 Aboriginal Community Controlled Health Services in over 304 clinics and health settings. Our very first AMS started in Redfern and has 47 years of experience to draw upon.

We provide about three million episodes of care each year for about 350,000 people which is provided by almost 6,000 staff. In very remote areas, our services provided about one million episodes of care. Over 50 per cent of the workforce is Aboriginal and we are working at increasing that.

There are many gaps in our Aboriginal Community Controlled Health Services and their holistic approach in delivering comprehensive primary care to our people, no matter where they live. We are mapping those gaps. Our aim is to ensure full coverage for our people.

We are funded by the Australian Government to support improvements in Indigenous health through the Aboriginal Community Controlled Health Services network and to bring the voices of those services into health policy decisions in Canberra.

NACCHO is independent of, trusted by and offers a strong voice to the federal government for the provision of specific community sector health care needs for Aboriginal people that is controlled by Aboriginal people. This ensures a strong voice in policy work and participation in policy development and legislation advocating and dealing with the issues as they arise or as reforms are discussed.

I coordinate 25 staff who sit on some 60 national committees and bodies. Historically NACCHO has a proud tradition and has developed over the last 20 years a strong coalition of support with other NGO’s working across a diverse range of areas.

We offer an alternative point of view enhanced by years of dedicated experience. Aboriginal perspectives from our governing bodies and staff about culturally appropriate healthcare needs are admired and respected by government.

According to the Australian Bureau of Statistics Aboriginal and Torres Strait Islander peoples represented 2.8 per cent of the population counted in the 2016 Census or 649,200 people of whom 326,996 were females. The median age of an Aboriginal is 23 years and only one in ten reported speaking one of the 150 Australian Indigenous languages at home.

There were 18,560 births registered in Australia during 2016 (6% of all births) where at least one parent reported themselves as being an Aboriginal or about 2.12 babies per woman. Births to women aged under 30 years contributed three-quarters (73%) of the total fertility rate for Aboriginal women with the median age of 25.5 years when having their first child.

This is important, especially when you realise that our Aboriginal population will increase to one million people by 2030.

As many of you would know, the state of Aboriginal health continues to be cause for both national shame and requires national action. I’m still as frustrated as some of you are that we have not Closed the gap for Indigenous people, had meaningful reconciliation in this nation and enhanced Aboriginal women’s health.

I believe there is no agenda more critical to Australia than enabling Aboriginal people to live good quality lives while enjoying all their rights and fulfilling their responsibilities to themselves, their families and communities. Aboriginal people should feel safe in their strong cultural knowledge being freely practiced and acknowledged across the country. This should include the daily use of our languages, in connection with our lands and with ready access to resources.

Aboriginal people should feel free from racism, empowered as individuals and have educational opportunities, careers, and health services to meet their needs and overcome inequality, poverty and increase life expectancy.

Now the Australian Government’s 2007 commitment to close the gap between Indigenous and non-Indigenous life expectancy within a generation was welcome. But the Close the Gap agenda did not deliver on a fundamental change to the way governments work with Aboriginal people.

I want to be very clear that progress against the closing the gap targets is now stalling and, in many cases, is going backwards.

I am also concerned that the Government is now shifting the focus to ‘prosperity’ targets, when we don’t even have the basic targets on track.

The figures paint a staggering reality. The Australian Institute of Health and Welfare tells us that the mortality gaps are actually widening.

No government can preside over widening mortality gaps and maintain goals to improve life expectancy and child mortality rates. On average Indigenous men and women die 15 years earlier than other Australians. Indigenous people suffer chronic diseases that are entirely preventable and have virtually been eliminated in the non-Indigenous population: trachoma, rheumatic heart disease and congenital deaths as a direct result of the current Syphilis outbreak across Australia, are but three examples.

The Closing the Gap target to halve the gap in child mortality by 2018 is not on track. Our children are dying at almost three times the rate of non-Indigenous children and there is a clear disparity in birth outcomes for my people. So, we now all appreciate and understand that our services are on the frontlines of women’s healthcare every day.

But of course, it’s not all bad news, NACCHO, its affiliates and our hardworking member services have had recent success with various national health programs. As you know Alcohol consumption during pregnancy can result in birth defects and behavioural and neurodevelopmental abnormalities including Fetal Alcohol Spectrum Disorder (FASD).

NACCHO recently provided advice to mothers that included practical advice and assistance with breastfeeding, nutrition and parenting, monitoring of developmental milestones, immunisations status and infections controls in 85 health service sites in remote, regional and urban locations. The FASD Prevention and Health Promotion Resources worked and did help to reduce the impacts of FASD in Aboriginal and Torres Strait Islander communities. The information also provided an opportunity to engage our local communities about other health issues like tobacco smoking, substance misuse and improving diets.

On the ground, Through Better Start to Life campaign, our Northern Territory member Danila Dilba has recently begun offering home nurse visits, meaning Darwin children and families now have more culturally appropriate access to antenatal and postnatal care resulting in better pregnancy outcomes which is vital in the first 1,000 days of a child’s life.

We now know that Mums participating in this program have fewer low birth weight babies, higher rates of breastfeeding and very high infant immunisation rates. We are also seeing women accessing antenatal care earlier in their pregnancies.

As you are aware a key component of improving pregnancy outcomes is early and ongoing engagement in antenatal care through culturally appropriate and evidence based care suitable to the local community. Investment in the early years is the best way to improve disadvantage over the longer term.

RANZCOG and NACCHO members understand this, evaluations have shown success in improving uptake of care earlier in pregnancy, for the duration of the pregnancy and in post-natal care allows other opportunistic healthcare interventions, such as family planning, cervical screening and improving breastfeeding rates.

So, by wrapping services around families, locally focused programs like this are also important in helping guard against the development of chronic conditions in later life, such as rheumatic heart disease and kidney failure.

While in Alice Springs, the Central Australian Aboriginal Congress is targeting at-risk Indigenous children before they even start preschool. The Preschool Readiness Program has up to 10 places for children between the ages of three and four who have been identified as having developmental delays or come from challenging home environments.

The foundations for health are laid early in life and there is much to be done in the early years to give our kids the best chance of succeeding at school and throughout their life.

If services cater for their needs, Aboriginal women will use them. However, not all Aboriginal women have access to these programs and many still rely on mainstream services such as GPs and public hospital clinics. That’s why it’s so important that mainstream services embed cultural competence into health care delivery across the care continuum.

Aboriginal culture has many strengths that can provide a positive influence, such as a supportive extended family networks, connection to country, and language. This is where the community controlled health sector and Aboriginal Health Workers are uniquely placed.

Our services build ongoing relationships to give continuity of care so that chronic conditions are managed and preventative health care can be effectively targeted.

Studies have shown that Aboriginal community controlled health services are 23% better at attracting and retaining Aboriginal clients than mainstream providers. Through local engagement and a proven service delivery model, our clients ‘stick’.

The cultural safety in which we provide our services is a key factor of our success. They can help to create relationships and understanding between our women and healthcare providers, practical assistance for attending appointments and coordinating care.

Many frontline clinicians and policy makers feel it is beyond their role to deal with these issues, but understanding some of these concepts will lead to greater empathy in the interactions with Aboriginal women.

We must acknowledge that Closing the Gap is not only a technical policy matter, but is also a political issue. We are disadvantaged, we are marginalised, we are poor, we do not have the numbers to influence government to the extent that others do, but we keep on trying.

The statistical gaps arise from voicelessness, powerlessness and a historical and significant lack of resources.

Firstly, the funding myth must be confronted as it stands like a rock in the way of progress.

As my good friend Professor Ian Ring tells us the commonly held view that enormous amounts of money have been spent on Indigenous Affairs has led many to conclude that money is not the answer and a different focus is required.

The recent Productivity Commission Report found that per capita government spending on Aboriginal services was twice as high as for the rest of the population. But higher spending on Aboriginal people should hardly be a surprise. We are not surprised, for example, to find that per capita health spending on the elderly is higher than on the healthier young because the elderly have higher levels of illness.

Nor is it a surprise that welfare spending is higher for Indigenous people who lag considerably in education, employment and income and there would be something very wrong with the system if it were otherwise.

The key question in understanding the relativities of expenditure on Indigenous is equity of total expenditure, both public and private, in relation to need, but the Productivity Commission’s brief is simply to report on public expenditure. In relation to government expenditure on health services the picture is quite different. State and Territory governments spend on average $2.6 per capita on Indigenous people for every $1 spent on the rest of the population.

By contrast, the Australian Government spends $1.4 for every $1 spent on the rest of the population, notwithstanding that, on the most conservative assumptions, Indigenous people have at least twice the per capita need of the rest of the population because of much higher levels of illness. The Commonwealth, in particular, needs to do much more. This is massive market failure.

The health system serves the needs of the bulk of the population very well but the health system has failed to meet the needs of the Indigenous population. And the Australian Government knows this, that’s why, for over 40 years they have been funding ACCHSs because they know the evidence shows these services better meet those needs, but the coverage of these services is patchy and needs to be expanded.

Secondly, Aboriginal communities need to be properly resourced, and Aboriginal people need to be in control. Let’s put Aboriginal health in Aboriginal hands.

It is imperative that a person’s health be considered in the context of their social, emotional, spiritual and cultural wellbeing, and that of their community. We know that being able to better manage and control your own affairs is directly linked to improved wellbeing and mental health.

This is why Aboriginal Community Controlled Health Services are essential to closing the health gap. Often Aboriginal people are uncomfortable seeking medical help at hospitals or general practices and therefore are reluctant to obtain essential care.

For example, the policy of forcibly removing children from Aboriginal families until the 1960s may still engender distrust of the ‘system’ in Aboriginal mothers. Access to healthcare is extremely difficult due to either geographical isolation or lack of transportation.

Many Aboriginal people live below the poverty line so that services provided by practices that do not bulk bill are unattainable. The most well-intentioned mainstream services struggle to provide appropriate healthcare to Aboriginal patient’s due to significant cultural and language disparities. Aboriginal Community Controlled Health Services bridge these gaps.

Their focus on prevention, early intervention and comprehensive care has reduced barriers to access and unintentional racism, progressively improving individual health outcomes for Aboriginal people.

 And thirdly, greater access to education, employment and participation in the economy.

So, for those three reasons, NACCHO continues to call on the Australian Government to invest in the expansion of the Aboriginal Community Controlled Health Services, to reach more people living in isolated areas, and to provide more care options for women, including mental health and psychology services.

Recently NACCHO, RANZCOG and other college Presidents met with the Minister for Indigenous Health and other ministers in Canberra who are all determined to do everything possible to close the gap in health outcomes. Now your stated mission is in providing excellence in women’s health. Well let’s do that by including Aboriginal women with new practical measures advocated to government and policy makers.

By all means let us together develop new statements and guidelines, by contributing effectively to health policy debate, in providing representation on various external committees and advisory groups, and responding to requests for submissions with expert evidence-based opinion.

Together lets us continue to drive policy development for the betterment of all women’s health with a view to developing a set of policy imperatives that must be addressed by Governments. It is through Aboriginal community controlled health service delivery that we can best close the gap. But we need your assistance.

We need your help with community-developed programs, that accept our cultural beliefs and traditions about health issues like contraception, termination, or pregnancy.

Currently Sexually Transmitted Infections rates have increased; the current syphilis outbreak has now reached four states predominantly infecting 15-29-year old’s with 12 cases of congenital syphilis causing five deaths.

In this day and age this is unacceptable! NACCHO seeks your assistance to insist on regular STI testing, a national public STI education campaign, with enhanced and clear antenatal guidelines, supported by a workforce with mobile local team’s conducting health checks and testing for other STI’s like gonorrhoea, chlamydia, HIV, Hepatitis C and B. This is the best way for you as individuals and organisations to contribute to improved Aboriginal women’s health outcomes and wellbeing.

As a group of 100 pioneering passionate women I know we have all earnt the accolades, enjoyed the press coverage and have a certain status in life. Let’s make a difference by today by being outspoken advocates for Aboriginal women and inspiring the next generation of women to not ask but demand better access to health care. Aboriginal women are the best advocates and leaders for health and wellbeing in their own families and in the broader community.

Please help bring about change, please make a contribution to improving the lives of Aboriginal women by lobbying governments.

We need your capabilities and skill, the energy and drive to make an impact, your commitment of time to our cause, your ingenuity and passion. Help us by proving to be effective role models, mentors and influencers for the next generation of Aboriginal female leaders.

I hope that today is seen as an opportunity to reflect on these vital Aboriginal women’s health issues. I urge you to act and commit to real sustainable practical change.

Don’t wait for government, don’t wait for them to provide the solutions. Work it out ourselves and just move on. So, to all you people here today I invite you to get in touch with your local Aboriginal Controlled Health Services and our Aboriginal health workers and to all your policy makers you can call me at NACCHO.

I have lost count of the number of speeches I have given over the years on this subject regarding Aboriginal women’s health to numerous gatherings, meetings, conferences, roundtables and symposiums. I will continue to speak for up all of our sisters, aunties, mothers and grandmothers.

I don’t expect or desire any consensus today but I expect robust discussion leading to identify policy reform that can be implemented. We must advocate for more action, adopt new policy positions and increase investment in the Aboriginal community controlled sector.

I know that the fight for Aboriginal rights continues and that the future is looking brighter for our mob with your support.

Thank you again for having me here today and I welcome any questions that you may have.

NACCHO and @RACGP Aboriginal Health #Housing #Crisis #ClosetheGap #Socialdeterminants Overcrowding leads to poorer health outcomes for our Aboriginal and Torres Strait Islander peoples

 ” In the first of a series focusing on the coming third edition of the National guide to a preventive health assessment for Aboriginal and Torres Strait Islander people, newsGP examines the effects of overcrowding on health outcomes “

Download Brochure

National-Guide-prerelease-info-Flyer-2017

Many households in Aboriginal and Torres Strait Islander communities are deemed overcrowded, a situation that can lead to a wide range of health problems.

Author of RACGP article Morgan Liotta

The National Aboriginal Community Controlled Health Organisation (NACCHO) and the RACGP’s National guide to a preventive health assessment for Aboriginal and Torres Strait Islander people (the National Guide) and the Centre for Aboriginal Economic Policy Research’s working paper, The scale and composition of Indigenous housing need, define overcrowded households as those that do not meet the following requirements:

  • No more than two persons per bedroom
  • Children aged <5 years of different sexes may reasonably share a bedroom
  • Children aged ≥5 years of opposite sex should have separate bedrooms
  • Children aged <18 years and the same sex may reasonably share a bedroom
  • Single household members aged >18 years should have a separate bedroom, as should parents or couples

The National Guide reveals that Aboriginal and Torres Strait Islander families living in overcrowded circumstances are more susceptible to contracting infections through lack of hygiene from poor sanitation and close contact with others.

Added by NACCHOFor example, situations in which several people are sharing a single bathroom, and the bore water supply (on which many remote Aboriginal and Torres Strait Islander communities depend) struggles to maintain appropriate levels, result in inadequate fresh water for basic cleaning. Another example is the ease with which an infection can spread via bed linen when several children are sharing a bedroom.

Chronic ear infections (eg otitis media), eye infections (eg trachoma), skin conditions (eg crusted scabies), gastroenteritis, respiratory infections (overcrowding has been identified as a risk factor for pneumococcal disease), and exacerbation of family violence and mental health issues are all potential outcomes from overcrowded environments.

In remote areas, overcrowded households (more than two children aged <5 years) are associated with a 2.4-fold increased risk of the youngest child having otitis media.

According to the Systematic review of existing evidence and primary care guidelines on the management of otitis media in Aboriginal and Torres Strait Islander populations, these high rates of infection could be prevented if overcrowding in Aboriginal communities was improved.

Overcrowding can also present as an environmental stressor for people living in such households, including from issues such as a lack of privacy, which can have an impact on mental health. Research from the Australian Bureau of Statistics shows that 14% of Aboriginal and Torres Strait Islander people in remote areas cited overcrowding at home as this type of stressor, compared to 9% of those living in non-remote areas.

In addition, the Y health – Staying deadly: An Aboriginal youth focussed translational action research project addresses overcrowding as a potential factor when exploring issues of Aboriginal youth mental health.

However, other significant factors to recognise are that some houses need to accommodate for overcrowding due to extended family visits to deal with illness, mourning a death in the family, or sometimes for cultural reasons.

Various government strategies are in place to combat the negative impacts of overcrowding, including the National partnership agreement on remote Indigenous housing, funded by the Federal Government. This policy aims to assess the current state of poor housing conditions in Aboriginal and Torres Strait Islander communities, as well as issues of housing shortage and homelessness.

These strategies are working towards improving housing conditions in rural and remote areas, a key part in helping to close the gap between Aboriginal and Torres Strait Islander peoples and non-Indigenous Australians.

NACCHO and the RACGP’s National guide to a preventive health assessment for Aboriginal and Torres Strait Islander people, provides further information on overcrowding in the following chapters:

  • Hearing loss
  • Eye health
  • Respiratory health – Pneumococcal disease prevention
  • Mental health
  • The health of young people

How to access the National Guide:

The third edition of the National Guide will be available early 2018.

Free to download on the RACGP website and the NACCHO website:

www.racgp.org.au/national-guide/ and www.naccho.org.au

For further information, contact

RACGP Aboriginal and Torres Strait Islander Health on 1800 000 251

or aboriginalhealth@racgp.org.au

 

@NACCHOChair Aboriginal Health Press Release #Apology10 #StolenGeneration Reflections from national Aboriginal community controlled health organisations

The Apology Excerpt  – 13 February, 2008

 ” The time has now come for the nation to turn a new page in Australia’s history by righting the wrongs of the past and so moving forward with confidence to the future.

We apologise for the laws and policies of successive Parliaments and governments that have inflicted profound grief, suffering and loss on these our fellow Australians.

We apologise especially for the removal of Aboriginal and Torres Strait Islander children from their families, their communities and their country.

For the pain, suffering and hurt of these Stolen Generations, their descendants and for their families left behind, we say sorry.

To the mothers and the fathers, the brothers and the sisters, for the breaking up of families and communities, we say sorry.

And for the indignity and degradation thus inflicted on a proud people and a proud culture, we say sorry.”

1.1 National Aboriginal Community Controlled Health Organisation (NACCHO) Mr John Singer reflects on the momentous day

2.1 Vic: Ten years ago, VACCHO CEO  Ian Hamm welcomed words he had been waiting a lifetime to hear

2.2 Vic Ballarat and District Aboriginal Cooperative (BADAC) commemorates Apology – Ten Years anniversary

2.3 VIC : VAHS community commemorates the 10th Anniversary of the National Apology of the Stolen Generation 

3.NSW:  AHMRC reflects on progress that has been made since the National Apology was delivered by the Prime Minister in 2008

4. WA : Treasurer and Aboriginal Affairs Minister Ben Wyatt, says his father never recovered from being a Stolen Generations child

5. ACT : For a community to make any kind of good, strong progress, the solutions need to come says Harry Williams

6. NT : Danila Dilba ACCHO staff Darwin came out in force to attend the 10th Anniversary of the Apology Day

7. QLD : Apunipima ACCHO : Coen Well Being Centre FNQ hold their annual acknowledgement of Sorry Day/ Apology Day

7.2 QLD Wuchopperen ACCHO Cairns Helping to Close the Gap

8.Tas : A decade on from the national apology to the Stolen Generations, Aboriginal children in Tasmania continue to be removed at unacceptable rates.

Warning Intro Picture above and The ‘Stolen Generations’ Testimonies’ project website

The ‘Stolen Generations’ Testimonies’ project is an initiative to record on film the personal testimonies of Australia’s Stolen Generations Survivors and share them online.

The Stolen Generations’ Testimonies Foundation hopes the online museum will become a national treasure and a unique and sacred keeping place for Stolen Generations’ Survivors’ Testimonies.

By allowing Australians to listen to the Survivors’ stories with open hearts and without judgment, the foundation hopes more people will be engaged in the healing process.

View HERE

Aboriginal and Torres Strait Islander viewers should exercise caution when viewing this website as it contains images of deceased persons.The people speaking in this website describe being removed from family and community. They regard themselves as belonging to the Stolen Generations.

1.1 National Aboriginal Community Controlled Health Organisation (NACCHO) Mr John Singer reflects on the momentous day.

“2008 was a time that the Government seriously committed to doing better by Aboriginal and Torres Strait Islander people into the future, where we committed to Closing the Gap in life expectancy between Indigenous peoples and non-Indigenous Australians.

Today we commemorate this significant milestone whilst reflecting on the work that still needs to be done – the truth that still needs to be told and the work that still needs to happen to Close the Gap,”

We also welcome a commitment to convene a national summit on First Nation’s Children to address the very high rates of Indigenous children in out-of-home care, and prevent the emergence of another generation of children living away from family, community and culture,”

Marking the tenth anniversary of the Apology, the Chair of the National Aboriginal Community Controlled Health Organisation (NACCHO) Mr John Singer reflected on the momentous day.

Download the full NACCHO Press Release

NACCHO media release apology – 13 Feb 18 – FINAL

Still more needs to be done to ensure Aboriginal and Torres Strait Islander peoples live strong, proud and healthy lives, ten years after Prime Minister Kevin Rudd issued the Apology to the Stolen Generations and more than 20 years after the Bringing Them Home report.

NACCHO knows that closing the gap depends on putting Aboriginal Health in Aboriginal hands so they can guide dealing with the trauma and pain of the past.

“We know that Aboriginal and Torres Strait Islander peoples need to be in charge of their own development, health and wellbeing. And that is why Aboriginal Community Controlled Health Organisations (ACCHOs) are so important.”

ACCHOs put Aboriginal and Torres Strait Islander peoples in the driving seat of their own health. They consistently demonstrate better health outcomes for Aboriginal and Torres Strait Islander peoples than mainstream health services, at better value for money.

“Forty years on from the first community controlled service in Redfern, there are still regions where there is low access to health services and elevated levels of disease experienced by Aboriginal and Torres Strait Islander peoples. Government needs to fund what is working in improving Aboriginal health and provide funding for new ACCHOs in these regions.

“We could also do better if more funding for disease specific initiatives was provided by Government.

“We need to get serious about Closing the Gap and that means Aboriginal and Torres Strait Islander peoples and their organisations co-designing policies and service delivery,” Mr Singer said.

NACCHO acknowledges the streamlined funding from the Australian Government, signed on 1 July 2017 and mentioned by the Prime Minister in his recent Closing the Gap Statement to Parliament. The new funding arrangement streamlines the provision of our health service support funding so that we can better represent the needs of ACCHOs in our policy development and advice.

The anniversary of the apology is a day to reflect on the past but also to recommit to a brighter future for Aboriginal and Torres Strait Islander peoples.

2.1 Vic: Ten years ago, VACCHO CEO  Ian Hamm welcomed words he had been waiting a lifetime to hear.

“For the pain, suffering and hurt of these Stolen Generations, their descendants and for their families left behind, we say sorry,” Kevin Rudd, then prime minister, said in parliament.

The apology on 13 February, 2008, referred to a shameful national chapter in which indigenous children were forcibly removed from their families.

Mr Hamm was among them.

As a three-week-old baby in 1964, he was taken from his Aboriginal family by government officers and adopted into a white community.

Tens of thousands of other indigenous children were removed over successive generations until 1970, under policies aimed at assimilation.

Mr Hamm said Mr Rudd’s historic apology helped changed his own sense of identity.

“My country doesn’t argue about me any more – it gave me peace that my story, like so many others, wasn’t a matter of debate,” he told the BBC.

“I remember writing out my feelings the day after the speech and I called it: ‘Today is the day I wake up.'”

An estimated 20,000 members of the Stolen Generations are alive today. Many have described the apology as a watershed moment.

“It was a day I will never, ever forget in my life because we were being acknowledged as a group of people,” Aunty Lorraine Peeters told the Special Broadcasting Service.

Michael Welsh told the Australian Broadcasting Corp: “It’s made a big difference to me in my life, through my life, where I’ve journeyed.”

A woman watches the Australian government’s apology to indigenous peopleImage copyright Getty Images

A landmark 1997 report, titled, Bringing Them Home, estimated that as many as one in three indigenous children were taken and placed in institutions and foster care, where many suffered abuse and neglect.

A government-funded survivors group, the Healing Foundation, said it had a “profoundly destructive” impact on those removed and their families, many of whom had carried lifelong trauma.

‘Keep going’

Indigenous Australians, who comprise about 3% of the population, continue to to experience high levels of disadvantage.

On Monday, the government released an annual report showing that Australia is failing four of seven measures aimed at improving indigenous lives.

Mr Hamm said that much optimism about addressing inequality had not been fulfilled since the apology. However, he urged Australians not to give up.

“It’s easy to give in to despair and say it’s too hard, but for us, remembering a moment like [the apology] is a boost,” he said.

“It’s a breath of air into our lungs to revive you and keep you going.”

2.2 Vic Ballarat and District Aboriginal Cooperative (BADAC) commemorates Apology – Ten Years anniversary

February 13 2018 marks ten years since the Apology to Australia’s Indigenous Peoples.

Ballarat and District Aboriginal Cooperative (BADAC) attended a ceremony this morning to mark the occasion at Child and Family Services (CAFS) in Ballarat.

BADAC CEO Karen Heap acknowledged the deep significance of the day for the Aboriginal and Torres Strait Islander community in the broader Ballarat area.

‘This is such an important occasion. There are many current members of the regional Ballarat Aboriginal and Torres Strait Islander community who were either members of the Stolen Generations themselves, or have family members who were affected.

‘The broader community may not be aware that many of the Stolen children who were removed from families all around Victoria and even interstate, were brought here to the Ballarat orphanage.

‘These Aboriginal and Torres Strait Islander people have grown up without knowing their families, their culture, their language or where they belong.’

Ms Heap said that BADAC currently runs programs which help to support members of the Stolen Generations.

‘Many have stayed in Ballarat, and brought up their own families here. The Stolen Generations people are here and part of our community.

‘So thank you CAFS for hosting the event this morning, and thank you to everyone who came to commemorate this occasion. It was so heartening to see so many present, and to stand together, both Aboriginal and Non-Aboriginal people of Ballarat and district.’

2.3 VIC : VAHS community commemorates the 10th Anniversary of the National Apology of the Stolen Generation 

Today we gathered as a community to commemorate the 10th Anniversary of the National Apology of the Stolen Generation Event. We had some amazing guest speakers. Thank you to everyone who shared their journeys, it truly showed great strength.

3.NSW:  AHMRC reflects on progress that has been made since the National Apology was delivered by the Prime Minister in 2008.

On the 10th anniversary of the National Apology, we take time to reflect on progress that has been made since the National Apology was delivered by the Prime Minister in 2008.

The National Apology was a public acknowledgement of the pain and suffering caused by the Australian Government with the effort to build new relationships between Indigenous and non-Indigenous Australians with the aim of addressing social injustice. This had a profound effect on many Aboriginal and Torres Strait Islander people as it was the first public commitment to engaging and working together with Australia’s Indigenous communities.

The Apology was a step in the right direction and since then we have seen the Redfern Statement launched during the 2016 Federal Election, where Aboriginal and Torres Strait Islander organisations and services came together to call for better resources and real reconciliation. It was an inspiring display of self-determination and strength for these organisations and services to demand for a say on how the Government’s decisions affect their lives.

“We still have work to do. The Government must ensure the social determinants of health for Aboriginal and Torres Strait Islander peoples is a priority.” said Stephen Blunden, Acting CEO at the Aboriginal Health & Medical Research Council (AHMRC) of NSW.

In reviewing the Closing the Gap initiative, with only one of the seven national targets being on track, we need to do better. We must do better.

As the former Prime Minister mentioned in the National Apology: “A future where we harness the determination of all Australians, Indigenous and non-Indigenous, to close the gap that lies between us in life expectancy, educational achievement and economic opportunity.”

If we are to make any real and lasting change, we must accept our history, put aside our differences and come together and really listen to the needs of the Aboriginal and Torres Strait Islander peoples.

4. WA : Treasurer and Aboriginal Affairs Minister Ben Wyatt, says his father never recovered from being a Stolen Generations child

West Australian Treasurer and Aboriginal Affairs Minister Ben Wyatt, who says his father never recovered from being a Stolen Generations child, has warned that well-meaning policy will fail if indigenous Australians are excluded from its design and implementation.

In a speech to mark the 10th anniversary of Kevin Rudd’s apology to the Stolen Generations, Mr Wyatt said the historic moment in federal parliament was still cause for celebration because it put to bed “that vexed, sometimes cruel, debate about the legitimacy of the Stolen Generations”.

Mr Wyatt — a former army lawyer, graduate of the London School of Economics and cousin of federal Aged Care and Indigenous Health Minister Ken Wyatt — said young indigenous leaders now had opportunities his late father Cedric could only have dreamt of.

“(But) the reality is that when you have policies … designed to remove their identity, designed to disconnect them from family and culture … those impacts will be felt for generations and we are seeing that,” Mr Wyatt said.

He said efforts towards Closing the Gap could not succeed unless Aboriginal people were part of the change.

“Without Aboriginal involvement … we will continue to have the infuriating and frustrating figures that we’ve seen in our jails and children in care,” he said.

Mr Wyatt’s father was born at the Moore River Native Settlement, which gained international notoriety in Phillip Noyce’s 2002 film Rabbit Proof Fence.

“It was a journey that defined him because of what happened to him and his mother, a journey that he was never able to recover from,” Mr Wyatt said yesterday.

“He was a determined guy but he also had a fundamental weakness as a result of that disconnection with his own mother and his own family.”

5. ACT : For a community to make any kind of good, strong progress, the solutions need to come says Harry Williams

Ten years may be a lifetime in politics, but for many indigenous Australians, 2008’s national apology to the stolen generations feels like yesterday.

Harry Williams was just 15 when he stood in the hall of Parliament House in Canberra, and watched then prime minister Kevin Rudd deliver the country’s apology as emotions ran high all around him.

“It was overwhelming”:.

“People were crying, some people were angry – it was overwhelming at the time,” he said.

“I didn’t really understand exactly what was going on, but I did really.”

Now 25, Mr Williams is passionate about educating Australians about indigenous history, and says change in the country’s relationship with its first peoples had to come from within.

“For a community to make any kind of good, strong progress, the solutions need to come

6. NT : Danila Dilba ACCHO staff Darwin came out in force to attend the 10th Anniversary of the Apology Day .

A great day organised by the NT Stolen Generations Aboriginal Corporation and held at Larrakia Nation.

It was a great turnout to remember a great moment in our history

7. QLD : Apunipima ACCHO : Coen Well Being Centre FNQ hold their annual acknowledgement of Sorry Day/ Apology Day .

The day was held at the centre with other community organisations sharing their acknowledgements of this special event with Elders and community members

7.2 QLD Wuchopperen ACCHO Cairns Helping to Close the Gap

Wuchopperen Health Service Limited Chairperson Donnella Mills said the 2018 Close the Gap statement demonstrates much more needs to be done to achieve health, education and employment parity between Aboriginal and/or Torres Strait Islander peoples and non-Indigenous Australians.

Ms Mills said it was time that the government seriously committed to doing better by Aboriginal and Torres Strait Islander peoples, now and into the future, through real partnerships which are community driven and community led.

‘It is very good news that a range of targets, including child mortality, early childhood education and year 12 attainment are on track. The challenge is that other targets, life expectancy, literacy and numeracy, and employment, remain out of reach,’ Ms Mills said.

‘Wuchopperen echoes the call of our peak body, the National Aboriginal Community Controlled Health Organisation, for dedicated disease specific funding to be made available to Aboriginal Community Controlled Health Organisation where populations are particularly vulnerable.’

‘In this, the tenth year since the Apology, it is timely to recognise that historical trauma, dispossession, government control and loss of culture, are just some of the social determinants which impact on people’s health, and the ability for people to manage their own health. Wuchopperen recognises the complexity of peoples’ lives and the range of factors which impact health, and provide a comprehensive suite of services to address these.’

‘Wuchopperen is looking forward to being part of the conversation regarding the Close the Gap targets which cease in 2018, and contributing our experience and expertise to formulating new, national goals in real partnership with government

‘These goals must be underpinned by the principles of Aboriginal and/or Torres Strait Islander self – determination, freedom to plan our lives; control, a voice and decision making powers over our own affairs; and finding solutions to the issues that affect us.’

Closing the Gap: What Wuchopperen Health Service Limited Is Doing

TARGET: Close the gap in life expectancy within a generation (by 2031)

Wuchopperen’s health team consists of a multi-disciplinary team of health workers, doctors, registered nurses, allied health professionals, counsellors, psychologists, wellbeing workers indigenous liaison officers, and visiting specialists.

TARGET: Halve the gap in mortality rates for Indigenous children under five within a decade (by 2018)

Wuchopperen’s Child Health service provides health education and support to families to make healthy lifestyles choices for their children by keeping immunisations up to date, scheduling appointments for continuity of care health checks, and 100% implementation of care plans for all our patients to ensure they receive the best possible care.

This allows us to:

  • Identify risk factors through the increased uptake of Child Health Checks and develop appropriate intervention strategies in conjunction with parents and/or carers;
  • Reduce the adverse intermediate health outcomes in relation to children with chronic diseases; and
  • Improve and enhance education and awareness of the importance of immunisation to families.

Wuchopperen also provides a dedicated program for mum’s having their first Aboriginal and/or Torres Strait Islander baby. The Australian Nursing Family Partnership Program is available to first-time mothers of Aboriginal and/or Torres Strait Islander children who are under 26 weeks in their pregnancy. The Program runs from pregnancy until the child is two. The focus is to provide home visiting program to mothers, babies and significant family members to ensure that the child has the best possible start to life.

Staff support:

  • Safe sleeping using PEPI pods;
  • Implementation of the Circle of Security;
  • Parent group meetings; and
  • Support for fathers to become involved in their child’s life.

TARGET: 95 percent of all Indigenous four-year-olds enrolled in early childhood education (by 2025) – renewed target

TARGET: Close the gap between Indigenous and non-Indigenous school attendance within five years (by 2018)

TARGET: Halve the gap for Indigenous children in reading, writing and numeracy achievements within a decade (by 2018)

Wuchopperen’s Children and Family Centre is an early intervention and prevention program providing a holistic approach to bringing together education, health and family support. The programs are tailored to suit our community to best support our Aboriginal and Torres Strait Islander families with children from birth to nine years of age and include:

  • Delivery of play based early childhood activities to nurture developmental pathways and life trajectory of children;
  • Capacity and resiliency support to enable families to support their children and access early childhood education and care; and
  • Delivery of parenting programs and family support services to enable connections and strengthen linkages of families to appropriate support services.

Program in focus

Wuchopperen supports early education in a range of ways including running the HIPPY (Home Interaction Program for Parents and Youngsters) Program, a free, family friendly, two year program which helps children achieve at school.

HIPPY benefits pre-Prep children by:

  • Encouraging a love of learning
  • Maximising their chance of enjoying and doing well at school
  • Promoting language and listening skills and developing concentration
  • Building self-esteem and confidence in learning
  • Improving relationships between parents and children.

TARGET: Halve the gap in employment outcomes between Indigenous and non-Indigenous Australians within a decade (by 2018).

Wuchopperen currently has 68% staff identifying from Aboriginal and/or Torres Strait Islander descent. Only 31% of Wuchopperen roles are Identified, reflecting the fact that many non-Identified positions are being filled by applicants identifying as Aboriginal and/or Torres Strait Islander.

Placements

Wuchopperen values its relationship with the community and the opportunity for students to gain experience in the workplace is an element of this commitment.

During the 2016-17 financial year Wuchopperen supported eight students to participate in a work placement in a variety of disciplines, including health workers, and fifth year medical students.

8.Tas : A decade on from the national apology to the Stolen Generations, Aboriginal children in Tasmania continue to be removed at unacceptable rates.

Commenting on the most recent statistics about the removal of Aboriginal children from their families, Tasmanian Aboriginal Centre Manager Ms Lisa Coulson said in Launceston today,

“Aboriginal children in Tasmania are over 3 times more likely than other children to be the subject of child protection orders, to be removed from their families, and to be placed in out of home care (Australian Institute of Health and Welfare, Child Protection Australia 2015-16, Tables 4.4 and 5.2). The 1997 Report of the Inquiry into the Separation of Aboriginal Children from Their Families, the Bringing Them Home report, made 54 recommendations about how to stop that unacceptable situation.

Many of those recommendations found further support in our own Tasmanian study of child protection issues but Tasmanian authorities have ignored all our efforts to stop the trend of removals.

Minister Jacquie Petrusma most recently has ignored our calls for greater Aboriginal community involvement in child protection decisions, flying in the face of changes made in most other Australian States.”

Ms Coulson said that closing the gap in social outcomes and avoiding a repetition of the stolen generations “must have Aboriginal community decision making at its core, but that is exactly what is still lacking in Tasmania. Consistently with the most recent calls for a “refresh” of the COAG targets to close the gap by ensuring greater Aboriginal decision making in governmental processes, we are calling on the Tasmanian government to restore jurisdiction for child safety to the Aboriginal community.

Having destroyed our community structures and taken our children away, governments need to fund these new processes to ensure both a healthier future for our children and more empowered Aboriginal community structures for the future. We are up to the challenge”.

Lisa Coulson
Northern Regional Manager and Children and Families Spokesperson
Tasmanian Aboriginal Centre

NACCHO Aboriginal Health #Saveadate and The #Apology10 :The fact is that most of the social and health problems we see in communities today are linked to Intergenerational Trauma says Richard Weston CEO @HealingOurWay

 ”  The fact is that most of the social and health problems we see in communities today, from family violence and suicide to high rates of incarceration and child protection, can be linked to Intergenerational Trauma

So if we want to create a different future and close the gaps that still exist between Aboriginal and Torres Strait Islander people and other Australians, we need to stop putting Intergenerational Trauma in the too-hard basket.

The National Apology to the Stolen Generations in 2008 was a landmark event. It was a moment of truth telling which is critical when you’re trying to heal from trauma. But it was a starting point not a solution. The latest progress report on Closing the Gap shows that efforts to address appalling levels of disadvantage have made marginal improvements, in spite of billions of dollars in government funding.

Closing the Gap is complicated, but it’s not impossible. We just need to invest in strategies that have been proven to work and be prepared to invest beyond political cycles and social fads.

We also need to listen to what Aboriginal and Torres Strait Islander communities tell us will work.”

Richard Weston, a Meriam man who was born on Gadigal country and grew up on Noongar Boodja and is now on Ngunnawal Country, is this week’s host on the @IndigenousX Twitter account and is tweeting with the #Apology10 hashtag. See Full Croakey article below

Communities across Australia, from Kununurra to Mildura, Casuarina to Logan, the Mornington Peninsula to Cherbourg and Muswellbrook to Adelaide, will come together this month to commemorate todays 10th anniversary of the National Apology to the Stolen Generations on 13 February 2008.

See this list of events.

In this anniversary article for Croakey, The Healing Foundation CEO Richard Weston says Australia must understand that the impacts of the Stolen Generations policies, and other brutal acts of colonisation, are not consigned to the past, but “very much part of the here and now”. He says we need a serious commitment to tackle unresolved and intergenerational trauma in Aboriginal and Torres Strait Islander communities

#Apology10 is also hosting a free community concert in Canberra to mark #Apology10, featuring Archie Roach, Shellie Morris, The Preatures, Busby Marou and Electric Fields, hosted by Myf Warhurst and Steven Oliver.

See also this video series marking the National Apology being published by IndigenousX – featuring Uncle Jack Charles, Amnesty Australia’s Roxanne Moore, and Gavan Moor and Chris Dunk.

 Download the 6 Page 2018 Aboriginal / Health  days and events calendar updated 6 February  HERE

NACCHO Aboriginal Health 2018 Save a date Feb 6

National Apology was starting point, not solution: Stolen Generations trauma continues

Anniversaries are a good time for reflection and as we commemorate the 10th anniversary of the National Apology today, I hope we can use the momentum to achieve something we’ve never managed to realise before—a serious commitment to tackle unresolved and Intergenerational Trauma in Aboriginal and Torres Strait Islander communities.

Ten years on from the Apology, and 20 years on from the tabling of the Bringing Them Home report that recommended that apology in the first place, there are still thousands of our people held back by the impact of trauma. Almost every Aboriginal and Torres Strait Islander family is affected in some way.

To give you an idea of what I mean, more than 12 per cent of the people who gave evidence of abuse to the recent Royal Commission into Institutional Responses to Sexual Abuse were Aboriginal or Torres Strait Islander. But we’re not just talking about events of the past. A study in Western Australia found that one in five Aboriginal children were living in families now, where between seven to 14 major life stress events had occurred in 12 months.

Most Australians prefer to think about the Stolen Generations—and other brutal episodes in 230 years of colonisation—as a phenomenon of the past. But the impacts are very much part of the here and now.

Trauma affects the way people think and act and overwhelms their ability to cope and engage. If people don’t have the opportunity to heal from trauma, it’s likely that their experiences and negative behaviours will start to impact on others, particularly children who are susceptible to significant developmental damage when they experience trauma at a young age.

This has created a cycle of trauma, where the impact is passed from one generation to the next, creating a snowball effect of cumulative damage. Research backs this up. The Stolen Generations and their children and grandchildren are twice as likely to be arrested by police and a third less likely to be in good health, compared to other Aboriginal and Torres Strait Islander people who are already at a disadvantage.

 

The Healing Foundation is finalising the first full analysis of current needs for the Stolen Generations, particularly as they enter the aged care sector, and to address issues like national reparations. When we talk to members of the Stolen Generations, they tell us over and over again that re-building families through culture and healing is a key priority.

Why? Because a traumatised person can’t benefit from programs around education and training.  Healing strategies must be implemented alongside enablers like employment, education and economic empowerment, otherwise we will keep wasting taxpayer dollars focusing on symptoms alone.

The Healing Foundation has shown that investment in the right programs will create long term change and reduce the burden on public funds.  Over the last eight years we’ve seen reductions in violence, juvenile justice rates and out-of-home care for children where healing programs have been implemented.  For example, our men’s healing programs have led to a 50% reduction in contact with Corrective Services and a drop in family violence, while programs for young people have potentially reduced contact with the protection system by 18.5% and the juvenile justice system by nearly 14%.

To replicate these successes across Australia, we need to scale-up our healing efforts and focus on families and communities, rather than individuals.

Today will be a day of celebration to mark a major step forward in the process of healing and reconciliation.  But it’s also a day when we need to take stock of what’s working and what’s not. Over the past few weeks I’ve been reminded by young people in our communities that the future holds a great deal of hope. Despite the wrongs of the past, many of them are optimistic and motivated to create change. This gives me hope that we will have something more positive to report after the next decade—and a different future, built on a foundation of healing.

 

NACCHO Aboriginal Children #CloseTheGap #Apology10 Are we creating a new “ #StolenGeneration ” ? In care 2017 17,644 in 2008 9,070

“An estimated 17,664 Aboriginal and Torres Strait Islander children were in out-of-home care in 2017, compared with 9,070 a decade ago

The number of Indigenous children removed from their families has risen rapidly since former prime minister Kevin Rudd’s national apology to the Stolen Generations in 2008.

The removal of children from Indigenous communities is skyrocketing and has become a “national disaster

The majority of our children live in loving homes where they’re nurtured, they have to go to school, they have inspirations and aspirations — this should be the goal for all of our children.”

Mr Andrew Jackomos Australia’s first and only Aboriginal children’s commissioner (Just Retired ) said he thought targets to decrease the numbers of Indigenous children going into care were not practical, and could result in some children staying in unsafe homes .See Part 2 Below

The compounding nature of intergenerational trauma continues to see successive generations of Aboriginal and Torres Strait Islander children impacted by the costs of colonisation. We need to be talking about where that fits into the ( Australia Day Jan 26 ) celebrations we see taking place across the country.”

– Sharron Williams, SNAICC Chairperson see part 3 below

Check out the website for some great resources to download for #Apology10
We have to understand and accept our history in order for us to make the future we want. healingfoundation.org.au/apology10/

Full interview: Wednesday 7 February, 9pm on NITV (Channel 34)

Ten years after he issued a National Apology* to the Stolen Generations and those forcibly removed from their families and communities, former Prime Minister Kevin Rudd speaks to Living Black’s host, Karla Grant.

It was Rudd’s experiences from his childhood and the inspiration of Gough Whitlam that led him to attend young Labor meetings from the age of 15 years old and then to join the Labor party some years later. He became Australia’s 26th head of government on 3 December 2007.

The National Apology was one of the first acts in Parliament Rudd accomplished when he was appointed Prime Minister. On 13 February 2008, he led the Apology for the “profound grief, suffering and loss” caused by passed policies.

“We couldn’t get to the business of closing the gap between Indigenous and non-Indigenous Australians until we had the guts from wider Australia to say sorry for the appalling treatment,” Rudd tells Grant.

“It was an elemental response as a human being, knowing how deeply we had wronged this country’s First People.”

Rudd addresses crucial issues facing Indigenous people in the NITV interview, including the Turnbull Government’s rejection of the Referendum Council’s proposal to have an Indigenous voice in Parliament.

“I don’t endorse Turnbull’s reaction at all,” Rudd says. “I know it’s pretty hard to get consensus among Indigenous leaders but when it emerges in the tone in which it was reflected in the document coming out of Uluru, my first response is, you treat that with a lot of respect, and secondly I ask myself, what’s wrong with a representative body if it’s powers are advisory? …

“I certainly don’t have any problems at all with the voice to Parliament. I think where my views have changed, and I’ve reflected this recently, is, I think we are on a trajectory towards a treaty. I don’t know when and I don’t know what, but I think we won’t achieve final reconciliation until that is done.”

Watch Karla Grant’s full Living Black interview on Wednesday 7 February, 9pm on NITV

The full episode will be on available on SBS On Demand

Part 1 #Apology10 Key Messages

  • The National Apology made in Federal Parliament on 13 February 2008 was a landmark event, as the first formal, national recognition of past atrocities and a first step towards restitution.
  • It was a key recommendation from the Bringing Them Home report, which had been tabled in Parliament a decade earlier.
  • It was a significant event for members of the Stolen Generations and their families, the wider Aboriginal and Torres Strait Islander community and other Australians.
  • Many Stolen Generations members felt that their pain and suffering was acknowledged and that the nation understood the need to right the wrongs of the past.
  • But the Apology speech was a starting point – not a solution.
  • The Healing Foundation was formed following community consultation after the Apology, to address the ongoing healing needs of the Stolen Generations and their descendants and communities.
  • It has made some critical progress but we need to scale-up the healing response and commit to strategies that have been proven to reduce the impact of unresolved trauma.
  • There’s still a lot of work to be done. A lack of action in the past has compounded the trauma experienced by the Stolen Generations and also the impact of Intergenerational Trauma. It’s also created bigger problems to fix, at a greater expense to the taxpayer.

The ongoing burden

  • Most of the social and health problems we see in Aboriginal and Torres Strait Islander communities today can be linked to Intergenerational Trauma. This includes family violence, suicide and high rates of incarceration and out-of-home child protection.
  • On the 10th anniversary of the National Apology, The Healing Foundation is calling for more funding and a long term commitment to address Intergenerational Trauma so that we can:
  • Finally heal the unresolved trauma that has been plaguing communities for decades
  • close the gap on opportunity and create a better future
  • Stop wasting taxpayer dollars on programs and plans that are doomed to fail because they’re near-sighted and not based on the needs of our people
  • The call for a National Intergenerational Trauma Strategy is linked to the Healing Foundation’s Action Plan for Healing which received federal funding this year.
  • As part of that plan, The Healing Foundation is building Australia’s first thorough study of the current needs of the Stolen Generations, which will give us a framework for looking at specific aged care requirements, national reparations and healing-on-a-larger-scale, for individuals, families and communities

Celebrating #Apology10

  • As well as focusing on the work that still needs to be done, the 10th anniversary is a time to keep building awareness about the Stolen Generations period.
  • Acknowledgement and truth telling is an important part of the ongoing healing journey. We need everyone to understand what happened and how it continues to affect Aboriginal and Torres Strait Islander people today, so that they can be part of solutions in the future. It’s about healing our past and building our future
  • The Healing Foundation is coordinating a number of commemorative activities including:
  • Community events in schools and public places around Australia
  • A concert on the lawns of Federation Mall, featuring some of Australia’s greatest Aboriginal and Torres Strait Islander entertainers
  • A community service announcement which will focus national attention in this important milestone
  • Resources to build awareness about the impact of Intergenerational Trauma

 Background

The Stolen Generations story

  • We don’t know how many children were stolen but the Bringing Them Home report estimated at least 1 in 10, and maybe as high as 1 in 3, Aboriginal children were forcibly removed from their families, between the early 1900s and right up until the 1970’s.
  • That means tens of thousands of children were stolen, as part of deliberate assimilation policies adopted by all Australian governments.
  • Many of them were raised in institutions, without any contact with family or culture and many of them suffered abuse and neglect
  • Every Aboriginal and Torres Strait Islander person has been affected by the Stolen Generations in some way.

What is Intergenerational Trauma?

  • If people don’t have the opportunity to heal from trauma it’s likely that their experiences and negative behaviours will start to impact on others, particularly children who are susceptible to significant developmental damage when they experience trauma at a young age.
  • This creates a cycle of trauma, where the impact is passed from one generation to the next, creating a snowball effect of cumulative damage.
  • In the case of the Stolen Generations, parents might also pass on the impacts of institutionalisation finding it difficult to know how to nurture their own children because they were denied the opportunity to be nurtured themselves.
  • Research has shown that people are not just effected by the traumatic events that they directly experience. Witnessing or hearing about trauma for their family or community also has a direct impact.

About The Healing Foundation

  • We partner with communities to address ongoing trauma caused by the disruption and mistreatment of Aboriginal and Torres Strait Islander people over the past 200 years. This includes actions like the forced removal of tens of thousands of children from their families which created the Stolen Generations.
  • We fund and support local healing programs that have been designed with local people and work at the individual, family and community level. These programs combine Aboriginal and Torres Strait Islander culture and knowledge with best practice in western trauma theory.
  • The Healing Foundation is helping to create a different future by generating new research and resources to establish an evidence-base for healing and best-practice strategies, building capacity in Aboriginal and Torres Strait Islander communities and strengthening the healing workforce through training support.

Part 2 Removing children from Indigenous communities ‘a national disaster’

From The ABC

Andrew Jackomos, who has finished his post in Victoria after five years, said his work had revealed shocking and tragic stories where children in state care had been denied contact with relatives and their culture.

“I think it’s a national disaster around the nation — and I think every state is a national disaster — if you look at the level of over-representation of our children in out-of-home care,” he said.

Mr Jackomos has urged the Turnbull Government to act.

“There should be one in every jurisdiction, including at a national level, which there is not.”

Mr Jackomos said he thought a lack of oversight on government agencies had led to this gross over-representation.

“Yes, people took their eyes off it. Government, and I think some parts of the community, should have done more,” Mr Jackomos said.

“We had many of the right programs and policies in place, but there was a lack of governance.”

Mr Jackomos, a Yorta Yorta and Gunditjmara man, also said he was disappointed by the Prime Minister’s rejection of the Uluru Statement last year.

The statement called for a constitutionally enshrined “voice to parliament”, which could provide advice on issues and legislation affecting Aboriginal and Torres Strait Islander people, including on child-protection concerns.

“I think it’s very sad. This was a well-thought-out plan from our leaders from across the nation to take it further, and the sad thing is the current Commonwealth Government is failing to act — for the reasons best known to themselves.”

The number of Aboriginal children placed with relatives and kin, or with Indigenous foster carers, has decreased in the past decade, according to the Productivity Commission.

In Victoria, there is some hope that an Australian-first pilot, advocated by Mr Jackomos, will see more children in foster care returned to their relatives.

The Aboriginal Children in Aboriginal Care program has transferred the case planning and management of dozens of children to a select few Aboriginal organisations.

“Our children will go home quicker, either to immediate family or kin, when they’re in our care,” Mr Jackomos said.

“I’m proud that some kids are going home earlier, I’d love to see all kids [in out-of-home care] go home earlier.

“I’m glad now that we do have a commitment to do it right, but we have a long way to go.” On Dja Dja Warrung country, in central Victoria, the Bendigo and District Aboriginal Co-operative is trialling the program with about a dozen families, chief executive Raylene Harradine said.

Part 3 The impact that colonisation continues to have on Aboriginal and Torres Strait Islander children today : SNAICC

SNAICC acknowledges the impact that colonisation continues to have on Aboriginal and Torres Strait Islander children today. Increasing understanding of the lasting impacts of colonisation amongst all Australians is key to our reconciliation as a nation.

If we, as a nation, are to recognise 26 January as the day that the colonisation of Australia began, then I think it is our responsibility to also recognise the lasting impacts that that colonisation has had.

“The compounding nature of intergenerational trauma continues to see successive generations of Aboriginal and Torres Strait Islander children impacted by the costs of colonisation. We need to be talking about where that fits into the celebrations we see taking place across the country.”

– Sharron Williams, SNAICC Chairperson

Access to quality early years education is proven to have the greatest impact on a child’s lifelong education and employment outcomes, however, due to many barriers, Aboriginal and Torres Strait Islander children are only half as likely to access early education as non-Indigenous children.

Nationally, Aboriginal and Torres Strait Islander children are 9.8 times more likely to be living in out-of-home care than non-Indigenous children.

The atrocities that followed that date – massacres, dispossession, fracturing of cultural knowledge – continue to have a profound impact today, including continued disempowerment and disadvantage of our children and families.

“Many Aboriginal and Torres Strait Islander people recognise 26 January as a day of mourning, shared with community, and that is as much about the present and future as it is about the past.

“Our goal must be reconciliation, and that cannot be achieved if we do not acknowledge the true history of our country, and furthermore the reluctance to face that truth. We will not see outcomes improve until we witness that change of attitude on a greater scale.

“It’s impossible to heal when we’re still feeling the pain every day.”

– Sharron Williams

 

NACCHO Aboriginal Health 2018 #Saveadate Calendar Download : Features this week Dr Tracy Westerman’s 2018 Workshops Assessment and #SuicidePrevention in Aboriginal Communities Combined and #CulturalCompetency

 

” Tracy has now trained more than 22,000 Aboriginal and non-Aboriginal service providers, accrediting them in her unique tools and approaches — enabling them to identify early stages of risk in Aboriginal people.

She has also provided her suicide intervention programs to Indigenous communities throughout Australia, as well as programs that improve the cultural competence of those working with Aboriginal people.”

Dr Tracy Westerman learnt early how to be a strong, proud Aboriginal. Now WA’s Australian of the Year is teaching others to be the same

Read full article HERE or extracts below Part 3

See Save a dates for Dr Tracy Westerman 2018 Workshops Assessment & Suicide  Prevention in Aboriginal Communities Combined and Cultural Competency for Supervisors of Aboriginal People See Part 2 Below

Register early as limited workshops are available!

Workshops are delivered by Dr Tracy Westerman, a recognized leader in Aboriginal mental health, suicide prevention and cultural competency fields

Part 1 : Aboriginal Conferences, Events, Workshops, Health Awareness Days

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

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

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

Download the 50 Page 2018 Health days and events calendar HERE

2018-Health-Days-and-Events-Calendar-by-Zockmelon

Download the 6 Page 2018 Aboriginal / Health  days and events calendar updated 30 January  HERE

NACCHO Save a date 30 Jan 2018

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

Events have been selected on their basis of relevance to the broad Aboriginal health promotion and public health community in Australia.

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

To submit your events or update our info

Contact: Colin Cowell www.nacchocommunique.com

NACCHO Social Media Editor Tel 0401 331 251

Email : nacchonews@naccho.org.au

Part 2.1 Assessment & Suicide  Prevention in Aboriginal Communities Combined

Brisbane 18,19 & 20 July
Cairns     1, 2 & 3 August
Adelaide 15, 16 & 17 August
  • Free Cultural Competency profile
  • Ensuring Cultural compatibility in assessment and engagement
  • Culture-bound syndromes – type, nature and assessment
  • Depression in Aboriginal people. Treatment, assessment and intervention
  • Post traumatic stress and its manifestations
    • Halting the transmission of intergeneration trauma
  • Accreditation in four unique assessment tools
    • Acculturation Scale for Aboriginal Australians
    • Acculturative Stress Scale for Aboriginal Australians
    • The Westerman Aboriginal Symptom Checklist – Youth & Adults – a suicide risk screening tool for Aboriginal people
  • The nature of Aboriginal suicide – intervention and prevention frameworks
  • Effective engagement with suicidal Aboriginal clients
  • Translating cultural differences into suicide risk assessment
Part 2.2 Cultural Competency for Supervisors of Aboriginal People 
Sydney 18-19 October
Perth    1-2 November
  • Free General Cultural Competency profile
  • Cultural competence- talking through an experiential journey
  • Motivators & predictors of racial bias and how to ensure a culturally safe work environment
  • Increase knowledge of Aboriginal health, history, government policies & culture
  • Aboriginal Identity Formation and its role in retention and employment outcome
  • Managing retention of Aboriginal employees – what are the issues and how to address them
  • Common causes of employment cessation
  • How to support Aboriginal employees
  • Understand impacts of community, culture & historical context
  • Supervision and leadership models
  • Cultural learning style differences
  • Cultural competent organisations and what defines them
  • Increasing representation of Aboriginal employees across organisations

Download registration form

 

Part 3 :Dr Tracy Westerman now WA’s Australian of the Year celebrates the 20th year of Indigenous Psychological Services

As a psychologist, she now knows that reaction was about the desire to fit in at all costs.

“When you’re a kid you don’t want to stand out for any reason,” she says. “But I was just really lucky to have an environment that didn’t generalise racism. They’d say ‘That’s just that nasty person’, rather than, ‘All white people are this way’. And I have never, ever been into divisiveness. We are all Australians together.”

Besides, she says, the stakes are too high to make her work a black or white issue.

“We have kids in our communities as young as 10 who are choosing the option of death instead of life. This is not an Aboriginal issue any more, this is a human issue,” she says, her passion rising to the fore. “We are only as strong as our most vulnerable and Australians have always been concerned about our most vulnerable. I’m not a social media commentator, I’m not a politician, I’m very, very clear about what I want my platform to be.”

Tracey used the Australian of the Year platform on Thursday to do as she has long been doing — working to improve Aboriginal mental health and help prevent alarming rates of suicide.

As she celebrates the 20th year of Indigenous Psychological Services, a business she started because she could see her people weren’t getting the kind of help they needed — and which she is proud to say has never had any government funding — even she finds it hard to believe she almost walked away from psychology.

“The first three years at uni I struggled, the culture shock was pretty significant. I mean I did distance education, I never caught an escalator, I never caught a bus, crossing Stirling Highway was terrifying to me,” she says. “And then on top of that I had this concept of the sorts of things that worked for my people and I was being taught the absolute contrary of that. I thought I can’t be a psychologist; if this is what psychology is, I’ve got it wrong.”

“I’ve always done fast things, so marathon running was the best thing for me because it made me slow down. It was this real mental battle initially because I’d go out like a bull at a gate and then after 10km I’d pass out.”

Then the 22-year-old was offered a job working in Kalgoorlie and the Western Desert communities with child welfare. “My first job in Warburton was just after 60 Minutes had been in there to do the big expose on petrol and glue sniffing,” she recalls. “I’d never been in an environment before where there was solvent abuse and there are 5000 household substances you can use to get a high.

“Imagine something the size of Subiaco Oval and shopping bags littered as far as the eye can see, discarded shopping bags that kids had used to sniff with. I had one sibling group one day, four years of age all the way through to 12 — five of them, high as kites. It’s just heartbreaking.”

But she loved the communities and immediately felt she could make a difference. Initially she was like a bull at a gate, wanting to smash all the obstacles at once, but was guided by some wiser heads. “One of my elders said to me ‘It’s like a drop in a bucket. One day you help someone and it’s a little drop in the bucket, and the next day you help someone else and it’s another drop in the bucket and eventually the bucket gets full’,” she says.

The experience also made her all the more determined to prove that mainstream psychology methods simply weren’t effective in dealing with indigenous mental health and suicide prevention.

“I developed the first unique screening tool for Aboriginal youth (the Westerman Aboriginal Symptom Checklist — Youth, or WASC-Y), developed from the ground up and validated,” she says. “I didn’t realise that had never been done before, not just in Australia but globally. I started to think maybe we’re getting this wrong, maybe the suicides are escalating because we’re getting the risk factors wrong and no one bothered to check. So we checked and found that the risk factors were very different, and if you get the risk factors wrong everything going forward is wrong.”

“We ended up wearing Aboriginal badges on our shirts when we went out just so that people would know we were Aboriginal because every time you’d go out you’d be in an argument.”

In 1998, as she was nearing the end of her groundbreaking PhD, she struck out on her own. “I was 27, I quit government, I bought a fax machine for $300 and just started sending out faxes to people about my training workshops — $600 for four days, fully catered. And that’s how I started my business, in the front lounge of this house.

People started registering straight away, I just couldn’t believe it. But mostly the business was born out of pure frustration. I knew that you had to get into communities and skill up whole communities if you were going to make a difference.”

This seemingly innocuous document is shocking on so many levels.

Tracy has now trained more than 22,000 Aboriginal and non-Aboriginal service providers, accrediting them in her unique tools and approaches — enabling them to identify early stages of risk in Aboriginal people. She has also provided her suicide intervention programs to indigenous communities throughout Australia, as well as programs that improve the cultural competence of those working with Aboriginal people.

“You have to get people to identify unconscious bias and that’s really challenging. It’s quite common that they come up to me in tears,” she says.

She conducts an activity whereby she asks the participants to picture a group of Aboriginal people in a park. “And I go ‘OK, open your eyes’. And on the powerpoint there’s a couple of very well dressed Aboriginal tradesmen at work in the park.

And I say ‘Did you see this?’ And then you have another picture of some Aboriginal people drunk and dishevelled and lying in the park ‘Or did you see this?’ I am not doing it for the shock value. I’m doing this because the science tells us that this shifts people.”