NACCHO Aboriginal Remote Communities Health and #CoronaVirus News Alerts :  #APYLands  @Nganampa_Health @NLC_74 #CAAHSN @AMSANTaus @RACGP All ensuring remote communities are resourced , protected and provided with appropriate information #COVID19

 

“As health and medical research organisations, we are calling for an absolute priority to be given to minimising risk and preventing death in communities across central Australia.

A major priority in our endeavours is working with Aboriginal communities and support to the primary health services in the bush and our regional centres.

Things that might work in. the big cities simply won’t work out bush, so we need to focus on local solutions.

Both Aboriginal community-controlled and government primary health services face enormous day-to-day challenges—and we strongly support them as the real heroes of health care in remote Australia, from Aboriginal Health Practitioners, to nurses to allied health workers to doctors, to all staff doing such vital work “

CAAHSN would continue to be informed by COVID19  messaging from AMSANT Aboriginal Medical Services Alliance and the Department of Health.

AMSANT has already been supplying advice to member services, with a focus on updating vaccinations and a focus on day-to-day preventive measure such as had washing.

Read full press release Central Australia Academic Health Science Network Part 2 Below

Graphic above QAIHC

Read all NACCHO Corona Virus Articles HERE

” As GPs try to navigate national guidelines for coronavirus (COVID-19), a number of Aboriginal and Torres Strait Islander community leaders have stepped in to manage their own infection control.

For example, in the Northern Territory quite a few communities are putting in place their own procedures around how they’re going to manage it. ’ 

‘[They’re] isolating themselves from [the] outside and I gather even saying, “Actually, we don’t want health professionals coming in at the moment to keep ourselves safe”.’

Dr Tim Senior, Medical Advisor for RACGP Aboriginal and Torres Strait Islander Health, told newsGP. See report part 4 below

“We need to be vigilant and follow these guidelines in order to protect Anangu from this virus,

There have been no known COVID-19 cases among APY Lands residents to date, but the Prime Minister has expressed concern about the vulnerability of those in remote Indigenous communities, including the APY Lands.

During the 2009 A(H1N1) swine flu outbreak, Aboriginal and Torres Strait Islander people made up 11 per cent of all identified cases, 20 per cent of hospitalisations and 13 per cent of deaths. Indigenous people are 8.5 times more likely to be hospitalised during a virus outbreak.”

APY General Manager Richard King has issued the directive to all APY staff and contractors. The directive also has been issued to Nganampa Health Council and major allied non-government organisations. State and Commonwealth government agencies, that are not required to apply for a permit to enter the APY Lands, have been contacted seeking their co-operation.

Mr King said communities on the APY Lands were particularly vulnerable because of well-documented poor health and living conditions. See full press release part 3

Part 1 NLC

“ The NLC supports the NT Government’s call to cancel all non-essential trips to remote communities as it tries to prevent the spread of coronavirus to vulnerable populations and has taken steps to ensure that all NLC employees who have recently travelled overseas do not travel to remote communities unless they have been cleared to do so.

“We agree with the NT Government’s decision to ask all workers to cancel their trips if they are not essential and the same goes for NLC staff,”

NLC CEO Marion Scrymgour.

Part 1 :The Northern Land Council’s Executive Council met today with officials from the Northern Territory Department of Health and the Danila Dilba Health Service’s CEO Ms Olga Havnen to examine strategies and information focused on protecting Aboriginal communities in the NLC’s region from the risk of coronavirus.

The NLC supports the NT Government’s call to cancel all non-essential trips to remote communities as it tries to prevent the spread of coronavirus to vulnerable populations and has taken steps to ensure that all NLC employees who have recently travelled overseas do not travel to remote communities unless they have been cleared to do so.

“We agree with the NT Government’s decision to ask all workers to cancel their trips if they are not essential and the same goes for NLC staff,” said NLC CEO Marion Scrymgour.

Ms Scrymgour will meet with NT Tourism tomorrow (March 13) to discuss how tourism operators can minimise their potential impact on remote communities.

NLC chairman Samuel Bush-Blanasi said the NLC is working closely with the NT Government and health service providers to  working

“We want people to really think about their need to visit remote communities. Especially if they have returned from an at risk country they must not travel to Aboriginal communities and must take every precaution.”

NT Government website COVID19 Information for Aboriginal communities

  • There are currently no suspected cases of COVID-19 in any Territory communities.
  • Residents should stay alert but carry on with normal activities.
  • There is no risk to eating traditional animals and plants.
  • The virus is not spread by mosquito bites.
  • The virus is not spread on the wind.
  • The most important thing for everyone to remember is to maintain hygiene by:
    • Washing your hands
    • Avoid shaking hands with people who may be unwel
    • Stay at a distance of 1.5 m away from someone who is unwell
    • Coughing or sneezing into your elbow
    • Don’t go to crowded places if you’re unwell.
  • If you get sick, go to your health clinic.

Recordings in language

A Coronavirus (COVID-19) Public Health Remote Communities Plan has been developed and distributed to all remote Territory communities. This plan provides high level guidance and each community will tailor their individual plans to suit their specific circumstances and community requirements.

Part 2

At a Council meeting of the Central Australia Academic Health Science Network [CA AHSN] today, a call was made for decisive and urgent action on the prevention of COVID-19 spreading to remote Australian communities, Executive Director Chips Mackinolty said today.

“We are in this together, and we have a collective responsibility at all levels of government and health service delivery to keep people safe,” said Mr Mackinolty.

“As health and medical research organisations, we are calling for an absolute priority to be given to minimising risk and preventing death in communities across central Australia.

“A major priority in our endeavours is working with Aboriginal communities and support to the primary health services in the bush and our regional centres.

“Things that might work in. the big cities simply won’t work out bush, so we need to focus on local solutions.

“We believe it is critical that rapid and extensive testing be rolled out as soon as possible, so that such work is timely and localised. As a first step this should be located in Alice Springs, rapidly followed by other regional centres.

“Of paramount concern is that our health services—already severely under resourced—not be further burdened. Just as happened in the recent bush fire crises, we would see it as essential that Commonwealth-funded remote area health medical workers being brought in to help.

“Both Aboriginal community-controlled and government primary health services face enormous day-to-day challenges—and we strongly support them as the real heroes of health care in remote Australia, from Aboriginal Health Practitioners, to nurses to allied health workers to doctors, to all staff doing such vital work.

“Meanwhile, our research activities will limit fieldwork, and researchers recently overseas will not be allowed to travel remotely. This follows the initiatives already of some of our partner organisations

In any case, we will also seek to follow the recommendations of local Aboriginal community organisations in our work.

“A major priority, from the Commonwealth and NT governments should be a major effort in proving accurate and concise information to Aboriginal people—with a stron

Part 3 MEDIA STATEMENT: APY enacts border protection to reduce coronavirus risk

APY has introduced strict new rules for entry into its remote lands in response to the Federal Government’s concerns about the potential for coronavirus to spread in vulnerable Indigenous communities.

The Executive Board that governs the remote Anangu Pitjantjatjara Yankunytjatjara Lands, in South
Australia’s far northwest, addressed the threat of a coronavirus outbreak at its latest meeting.

The Board has resolved not to routinely issue entry permits for the next three months to anyone who has:

  • Been in mainland China from 1 February 2020.
  • Been in contact with someone confirmed to have coronavirus.
  • Travelled to China, Iran, South Korea, Japan, Italy or Mongolia.

If a person who wishes to enter the APY Lands has travelled to any of the affected countries, experienced coronavirus symptoms in the previous 14 days, been seen by a doctor and recorded a negative test, they must submit a copy of the test results along with a Statutory Declaration to be considered for an entry permit.

APY has the legal authority to exclude persons from entering the APY Lands pursuant to section 19 of the Anangu Pitjantjatjara Yankunytjatjara Land Rights Act. APY General Manager Richard King has issued the directive to all APY staff and contractors.

The directive also has been issued to Nganampa Health Council and major allied non-government organisations. State and Commonwealth government agencies, that are not required to apply for a permit to enter the APY Lands, have been contacted seeking their co-operation.

Part 4 RACGP 

Media report RACGP Dr Tim Senior : Chronic diseases and a lack of access to culturally appropriate care makes Aboriginal and Torres Strait Islander people vulnerable to coronavirus.

 

 

NACCHO Aboriginal and Torres Strait Islander #RuralHealth : @RuralDoctorsAus President and CEO says quality rural and remote health care essential to #ClosingtheGap

“Both Federal and State governments, right across the country, need to step up and invest in rural health if they are serious about this.

There have been numerous examples of initiatives developed to improve access to health care in rural and remote areas being extended into urban areas to prop up under-funded services in for the socially disadvantaged.

This has resulted in the unintended consequence of further disadvantaging Aboriginal and Torres Strait Islander people living in rural and remote Australia.

We need continued investment in health infrastructure and services aimed at addressing the disparity in health outcomes between those who live in the city and those who live in the bush… and this extends across both our Indigenous and non-Indigenous populations.

Without this, as a nation we are never going to close the gap, and the divide for the health outcomes of Aboriginal and Torres Strait Island people living in rural and remote Australia will never be addressed.”

Dr John Hall, President of the Rural Doctors Association of Australia (RDAA), said that without access to high quality health services in rural areas, the gap will never close.

Photo above : Here is what GPs said about working in Indigenous health

” I’m particularly concerned with successive government failure to halve Indigenous child mortality rates.

A lot of this is about access, it’s around health literacy.

It’s also about the holistic care, it’s also around education, housing and a whole range of other things”.

Australia needs to boost hospital and birthing facilities in rural and regional areas in order to overcome entrenched Indigenous health disadvantage, according to Rural Doctors Association of Australia CEO Peta Rutherford told SkyNews .

Watch SkyNews interview HERE 

Read over 70 Aboriginal Rural and Remote Health NACCHO Articles HERE

Another disappointing Closing the Gap Report, released this month [12 February 2020], demonstrates why health care in rural and remote Australia is a key driver to Closing the Gap in health.

“The Government’s Closing the Gap Report 2020 showed that the Gap between Indigenous and non-Indigenous Australians on key health indicators has not closed,” Dr Hall said.

“Two key health-related benchmarks were chosen by the

Government in 2008, with a target of halving the gap in child mortality by 2018, and to close the gap in life expectancy by 2031.

“Neither of these targets are on track.

“The main cause of Aboriginal and Torres Strait Islander child deaths are perinatal conditions such as complications of pregnancy and birth.

“With 85 per cent of these deaths occurring during the first year of life, maternal health and risk

factors during pregnancy play a crucial role.

“Access to quality, culturally safe, medical care is the most direct way of improving these outcomes,” Dr Hall said.

Similarly, life expectancy in Aboriginal and Torres Strait Islander people is strongly influenced by health and health care, with the report attributing 34 per cent of the gap to social determinants (such as education, employment status, housing and income), 19 per cent to behavioural risk factors (such as smoking, obesity, alcohol use and diet), leaving 47 per cent attributed to what is clearly a disparity in health outcomes and associated health care issues.

In rural and remote areas there is a noticeable difference of a more than six year reduction in life expectancy of Aboriginal and Torres Strait Islander males and females, when compared to those living in major cities.

This demonstrates a failure across the board in these key areas, all of which are influenced by the provision of quality health care.

“Clearly we can’t close the gap without a functional health system in rural and remote Australia,” Dr Hall said.

“And this cannot just be solved through funding Aboriginal Medical Services (AMS); the other parts of the health system need to be equally funded to service these communities in order to be able to provide the standard of care that will result in a reduction in the gap in health outcomes.

“We can’t have hospital services downgraded and expect to close the gap.

“We can’t have communities with no access to medical birthing services and expect to close the gap.

“We can’t have people needing to travel hundreds of kilometres to access cancer or surgical treatment and close the gap.

“We need quality rural hospitals, staffed by Rural Generalist doctors, with the skills needed to meet the needs of these communities in both the General Practice and hospital settings, if we are serious about improving health outcomes and actually closing the gap.

NACCHO congratulates the @RACGP Aboriginal and Torres Strait Islander Health Unit celebrating its 10-year anniversary this month

‘ If we do Aboriginal and Torres Strait Islander health well, we can’t help but influence the healthcare of all Australians.

It means better doctors, better healthcare teams and so it goes.
 
Everyone in this room has a story. Most of us are very rarely straight out of school. Often there are surrounding problems with finances or family illnesses – no one around here had a silver spoon-type journey to get where we are.
 
That’s the basis on which this faculty is based. That’s the soil from which we’ve built. That’s really important to remember.’

Dr Brad Murphy (the inaugural Chair ) told newsGP that improving Aboriginal and Torres Strait Islander health also helps improve the health of the nation. See full RACGP news coverage Part 2

Image above : The celebrations at the RACGP Aboriginal and Torres Strait Islander Health officially recognised its 10th anniversary on 19 February 2020.

Key contributors in the establishment of the faculty were honoured at an event on Monday 10th February, acknowledging their hard work and dedication to Aboriginal and Torres Strait Islander Health at the RACGP.

Pictured: Professor Jenny Reath, Dr Hung Nguyen, Associate Professor Brad Murphy and Alan Brown. Photo by Jalaru Photography.

Part 1 : The RACGP in 2019 deepened its commitment to Aboriginal and Torres Strait Islander health via a new Memorandum of Understanding with NACCHO

“The RACGP’s partnership approach with NACCHO is similar to that seen in clinical practice, with respect for the insights of Aboriginal and Torres Strait Islander peoples and organisations, and the experience of RACGP members,’ he said. ‘Our organisations’ relationship embodies this philosophy.
 
Each organisation has unique skills, knowledge and experiences, which, when combined with the other, really can make a difference in our efforts to improve healthcare for Australia’s First Peoples “

At a signing ceremony at the NACCHO 2019 AGM in Darwin attended by Federal Health Minister Greg Hunt, RACGP Vice-President Associate Professor Ayman Shenouda said the Memorandum of Understanding (MoU) represents a ‘special milestone’. Read full media coverage HERE

Link to all RACGP Aboriginal Torres Strait Islander Resources

Read over 20 Aboriginal Torres Strait Islander health and the RACGP articles published by NACCHO

‘ We’ve been able to provide help alongside the Australian Indigenous Doctors’ Association and Indigenous General Practice Registrars Network ahead of the exams,’ he said.

‘That’s important for the profession – it changes us all when we have Indigenous registrars in the college. That means Aboriginal and Torres Strait Islander people are our colleagues, and it means we listen better to people and learn how to provide culturally appropriate care.

What that means is that it gives patients a sense of relief – they don’t have to justify themselves or explain what’s happening,’ he said. ‘There’s this understanding of culture and its importance, and of the experience people may have had in the health system.

‘It gives a level of comfort.’

For GP Dr Tim Senior, the faculty’s medical advisor, the highlight of the first 10 years has been the support provided to Aboriginal and Torres Strait Islander registrars as they work towards becoming a GP.

In recent years, a number of Aboriginal registrars have started at Dr Senior’s workplace, the Tharawal Aboriginal Medical Service.

Part 2

RACGP Aboriginal and Torres Strait Islander Health Chair Associate Professor Peter O’Mara described the college’s work in this area as ‘a shining light’ at the faculty’s recent 10-year anniversary event.

‘I think our college stands out – we are leaders in this space, through the commitment of the whole organisation,’ he told the audience.

Founded in 2010, RACGP Aboriginal and Torres Strait Islander Health emerged out of an earlier unit within the college that began in 2006, alongside a standing committee.

Driven by Dr Brad Murphy, GP, Associate Professor and Kamilaroi man, as well as Professor Jenny Reath and influential Aboriginal health advocate Alan Brown, the unit became a faculty, with Dr Murphy as the inaugural Chair.

Associate Professor O’Mara told newsGP he felt humbled to be part of the process, given the work that had gone on before his time.

‘I feel very positive about where things are going to go in the future for us,’ he said. ‘While we are a leader in this space, we don’t want to rely on that – we want to keep getting better and better all the time.’

Dr Murphy told newsGP that improving Aboriginal and Torres Strait Islander health also helps improve the health of the nation.

‘If we do Aboriginal and Torres Strait Islander health well, we can’t help but influence the healthcare of all Australians. It means better doctors, better healthcare teams and so it goes,’ he said.

‘Everyone in this room has a story. Most of us are very rarely straight out of school. Often there are surrounding problems with finances or family illnesses – no one around here had a silver spoon-type journey to get where we are.

‘That’s the basis on which this faculty is based. That’s the soil from which we’ve built. That’s really important to remember.’

Professor Jenny Reath was a manager in the early 2000s, when the unit was first established.

‘We’ve had fabulous leaders, which is a big part of our success,’ she told newsGP.

‘What I love about Brad is his incredible vision. We had a unit and Brad said, “I think we should be a faculty”. He made that happen.

‘What I didn’t realise about becoming a faculty was the seat on the board and the influence that created – it has made a huge difference.

‘Brad was absolutely the right person at the right time.

‘We were eyeing Peter [O’Mara] off, hoping he could step into Brad’s shoes, and he has led us – gently, humbly, respectfully but very strongly – to engage with the council and the board, to lead us to the next stage. We are incredibly fortunate.’

Professor Reath’s own work in paving the way for the faculty was recognised with a commemorative plaque, alongside Associate Professor Murphy, GP Dr Hung Nguyen and Allan Brown.

After government funding to support Aboriginal and Torres Strait Islander health within the college ran out around 2005, Professor Reath remembers discussions about what to do next.

‘We thought, we can’t just stop. So the college funded the unit and standing committee,’ she said. ‘That was a landmark, funding it out of mainstream funds. We were the first college to do that.

‘I feel proud to be a member of the college, with the way it has worked in Aboriginal and Torres Strait Islander health. Enormously proud.’

NACCHO Aboriginal Health News : Read / Download Press Release responses to the 2020 #ClosingtheGap Report from #CoalitionofPeaks @closethegapOZ @NATSILS_ @SNAICC @SenatorSiewert @CAACongress @RACGP

“ These Closing the Gap reports tell the same story of failure every year

The danger of this seemingly endless cycle of failure is that it breeds complacency and cynicism, while excusing those in power.

People begin to believe that meaningful progress is impossible and there is nothing governments can do to improve the lives of our people.

The truth is that the existing Closing the Gap framework was doomed to fail when it was designed without the input of Aboriginal and Torres Strait Islander people. We know what will work best for our communities and the Prime Minister even acknowledges in this report that our voice was the missing ingredient from original framework.

The Coalition of Peaks has signed a formal partnership agreement with every Australian government, where decision-making on design, implementation and evaluation of a new Closing the Gap framework will be shared. Through this partnership, the Coalition of Peaks has put forward structural priority reforms to the way governments work with and deliver services to Aboriginal and Torres Strait Islander people.

Governments say they are listening to Aboriginal and Torres Strait Islander people. However, the true test in listening is translating the priority reforms into real, tangible and funded actions that make a difference to Aboriginal and Torres Strait Islander people right across our country.

This historic partnership could be the circuit-breaker that is needed. However, if they view this process as little more than window dressing for the status quo, the cycle of failure evident in today’s report is doomed to continue.”

Pat Turner, CEO of NACCHO and Co-Chair of the Joint Council on Closing the Gap, said that governments need to learn from these failures, not continue to repeat them.

Read Download the full Coalition of Peaks Press Release HERE

Read previous NACCHO Communiques this week

1.Coalition of Peaks Editorial Pat Turner

2.PM Launches CTG Report ( Download )

3.PM CTG Full Speech

4.Opposition response to CTG Report

“Every year for the last 12 years we have listened to a disappointing litany of failure – it’s not good enough, Indigenous Australians deserve better.

We are heartened by the developments last year with COAG and the Prime Minister agreeing to a formal partnership with the Coalition of Peaks on the Closing the Gap strategy.

Indigenous involvement and participation is vital – when our peoples are included in the design and delivery of services that impact their lives, the outcomes are far better.

However, now that partnership is in place, Australian governments must commit to urgent funding of Indigenous healthcare and systemic reform.

Preventable diseases continue to take young lives while unrelenting deaths in custody and suicide rates twice that of other Australians continue to shame us all.

As governments reshape the Closing the Gap strategy, we cannot afford for the mistakes of the past to be repeated.

Close the Gap Campaign co-Chairs, Aboriginal and Torres Strait Islander Social Justice Commissioner June Oscar AO and National Aboriginal and Torres Strait Islander Health Worker Association (NATSIHWA) CEO Karl Briscoe, have called on the government to invest urgently in health equity for Aboriginal and Torres Strait Islander peoples

Download full Close the Gap campaign press release HERE

Close the Gap Campaign response to CTG Report

” There was one glaring omission from the Prime Minister’s Closing the Gap speech this week. Housing did not rate a mention. Not a word about action on Aboriginal housing or homelessness.

Housing was not even one of the targets, let alone one we were meeting, but it must be if we are to have any chance of finally closing the gap between Indigenous and non-Indigenous Australians on all the other targets for life expectancy, child mortality, education and jobs.

Aboriginal and Torres Strait Islander people make up 3 per cent of Australia’s population but 20 per cent of the nation’s homeless. Aboriginal people are 2.3 times more likely to experience rental stress and seven times more likely to live in over-crowded conditions than other Australians.”

James Christian is chief executive of the NSW Aboriginal Land Council.

“For the first time ever, there is a commitment from all Australian governments, through COAG, to work with Aboriginal leaders through the peak bodies of Aboriginal organisations to negotiate key strategies and headline indicators that will make a difference.

So long as the negotiations continue in good faith and we stay the course together this should lead to a greater rate of improvement in coming years. Of this I am sure.

There is a commitment to supporting Aboriginal people by giving priority to our own community controlled organisations to deliver the services and programs that will make a difference in our communities while at the same time ensuring mainstream services better meet our needs”

Donna Ah Chee, Chief Executive Officer of the Central Australian Aboriginal Congress : Read full Report Part 1 below.

“Today is another day we reflect on the Federal Government’s inability to meet the Closing the Gap targets.

This report clearly shows that the gap will continue to widen if reforms aren’t translated into tangible, fully funded actions that deliver real benefits to Aboriginal and Torres Strait Islander people throughout the country.

The report reveals that progress against the majority of Closing the Gap targets is still not on track. The gap in mortality rates between Aboriginal and Torres Strait Islander people and non-Indigenous

Australians increased last year and there are very worrying signs on infant mortality.

The Federal Government needs to commit to funding solutions to end over-imprisonment of Aboriginal and Torres Strait Islander people and they must be implemented alongside other areas of disadvantage in the Closing the Gap strategy – health, education, family violence, employment, housing – in order to create real change for future generations.”

Cheryl Axleby, Co-Chair of NATSILS.

“We are deeply concerned about the Federal Government’s decision to not continue funding for remote Indigenous housing. Access to safe and affordable housing is essential to Closing the Gap,”

Nerita Waight, Co-Chair of NATSILS.

Download the full NATSILS press release HERE

NATSILS response CTG Report

” SARRAH welcomes the bipartisan approach by Parliamentarians who committed to work genuinely and collaboratively with Aboriginal and Torres Strait Islander leaders.

The potential contribution of Aboriginal and Torres Strait Islander Australians is far greater than has been acknowledged or supported to date.

There are many organisations working hard to close the gap, such as Aboriginal community controlled health organisations right across Australia, and Indigenous Allied Health Australia, the national Aboriginal and Torres Strait Islander peak allied health body.

Governments, through COAG, working with the Aboriginal and Torres Strait Islander Coalition of Peaks have the opportunity to reset the trajectory.”

Download SARRAH Press Release

Media Release SARRAH Closing the Gap

“ Many of our communities are affected by a range of adverse experiences from poverty, through to violence, drug and alcohol issues and homelessness.

Without an opportunity to heal from the resultant trauma, its impact can deeply affect children’s brain development causing life-long challenges to the way they function in the world.

It is experienced within our families and communities and from one generation to the next.

We need urgent action to support better outcomes and opportunities for our children.

SNAICC CEO, Richard Weston

Download the full SNAICC press release HERE

SNAICC Response to CTG Report

“Mr Morrison will keep failing First Nations peoples and this country until a genuine commitment to self-determination is at the heart of closing the gap.

The Prime Minister’s same old “welfare” rhetoric indicates that the Government really hasn’t got it.   While they say they are committed to the COAG co-design process the PM ignores the point that it is his Government continuing to drive discriminatory programs such as the Cashless Debit Card, the CDP program, ParentsNext and who are failing to address the important social determinants of health and wellbeing.

There are a few things this Government needs to do before they just “get people into jobs”, like invest in the social determinants of health and wellbeing and a housing first approach.”

Australian Greens spokesperson on First Nations peoples issues Senator Rachel Siewert

Download the full Greens press release HERE

The Greens Response to CTG Report

” Australia’s efforts to close the gap are seemingly stuck in a holding pattern.

Though Prime Minister Scott Morrison has hailed the beginning of a ‘new era’ of improving the health and life expectancy of Aboriginal and Torres Strait Islander people in the launch of the 12th Closing the Gap report, the results are all but unchanged.”

Read RACGP editorial

Part 1 : Donna Ah Chee, Chief Executive Officer of the Central Australian Aboriginal Congress

Continued

“It’s also important to recognise that there has been progress here in Central Australia both over the longer term and more recently. Since 1973, the number of Aboriginal babies dying in their first year of life has reduced from 250 to 10 per 1000 babies born, and life expectancy has improved on average around 13 years.

As recently as 2019 we have seen significant improvements across multiple areas.

“Alice Springs has experienced a remarkable 40% reduction in alcohol related assaults and a 33% reduction in domestic violence assaults. This is 739 fewer assaults year on year, or 14 fewer assaults per week”.

“There has been a 33% reduction in alcohol related emergency department presentation which is 1617 fewer presentations year on year or a reduction of 31 per week. Corresponding with this, there has been a decline in hospital admissions and, as noted in the MJA recently, ICU admissions. These are dramatic improvements,” she said.

“The proportion of babies born of low birth weight has halved and the rates of childhood anaemia and anaemia in pregnancy have declined markedly.”

“In addition to this the number of young people who reoffend and therefore recycle through youth detention has dropped dramatically.”

“Combining all of these factors, we are closing the gap on early childhood disadvantage and trauma and this will make a big difference in coming years in other health and social outcomes.”

There are however, still many issues to be addressed, especially with the current generation of young people, as too many have already experienced the impacts of domestic violence, trauma and alcohol and other drugs. Unfortunately, this has led to the youth issues experienced now in Alice Springs.

The NT government recently advised Congress that they are implementing strategies that are aimed at making an immediate difference while at the same time we know key strategies that will make a longer-term difference are already in place. New immediate strategies include:

  1. 14 additional police undertaking foot patrols and bike patrols in the CBD
  2. Police now taking young people home where it is safe to do so, rather than telling them to go home themselves
  3. The employment of two senior Aboriginal community police officers from remote communities and the recruitment of three others in town and two at Yuendumu
  4. The flexible deployment of the YOREOs to meet peaks in the numbers of young people out at different hours of the night
  5. The much more active deployment of the truancy officers to ensure all young people are going to school.
  6. Access to emergency accommodation options for young people at night

While progress overall is slower than it should be, it is important to acknowledge the successes we are having because of the good work of many dedicated community organisations and government agencies working together in a supportive environment, where governments are adopting evidence based policies.

NACCHO Aboriginal Health Resources Alert : @RACGP , NACCHO and @ahmrc to host a webinar series to complement their brand new Aboriginal and Torres Strait Islander health resource hub.

” The National Aboriginal Community Controlled Health Organisation (NACCHO) and the Royal Australian College of General Practitioners (RACGP) have worked together to develop resources for GPs and other health professionals to support culturally responsive primary healthcare for Aboriginal and Torres Strait Islander people, wherever they seek care.”

A new resource hub has been launched : See Part 1 below

 ” AH&MRC has also partnered with the RACGP to develop a webinar series. The webinars are on topics relevant to healthcare professionals employed within the ACCHS sector.” 

These webinars are published on the RACGP Website : See Part 2 below 

Part 1

 

A new resource hub has been launched on the RACGP website.

It is home to resources that support primary healthcare that is accessible, effective and valued by Aboriginal and Torres Strait Islander people.

Original published WAGPET 

The hub includes:

  • Good practice tables – building on the five steps towards excellent Aboriginal and Torres Strait Islander healthcare and five good practice tables provide activities for all members of the practice team with each activity linked to accreditation
  • Quality 715 health check resource – this one-page resource provides an opportunity for practice teams to reflect on what they are doing well and what could be improved to support quality Medicare Benefits Schedule (MBS) item 715 health checks for Aboriginal and Torres Strait Islander people
  • National Guide check (unit 561) – this edition of check provides case studies involving Aboriginal patients
  • Clinical audit – Identification – this audit aims to identify with the use of existing medical record software

To complement the resource hub, RACGP Aboriginal and Torres Strait Islander Health has developed a new webinar series titled, ‘I can see clearly now: Good experiences and great health outcomes through effective, culturally safe primary healthcare’.

The webinar series is presented by:

  • Ms Jacinta McKenzie, Integrated Team Care Supervisor, Indigenous Health Project Officer, Wellness Our Way at Country and Outback Health
  • Dr Mary Belfrage, GP and RACGP Fellow
  • Ms Ada Parry, RACGP Cultural and Education Advisor.

Webinar details

Webinar Title Date Time
NACCHO RACGP Resource Hub webinar Wednesday, 18 March 2020 7:00 – 8:00pm
Case study: Working together to achieve great health outcomes webinar Wednesday, 6 May 2020 7:00 – 8:00pm
Quality 715 health check and follow up webinar Wednesday, 10 June 2020 7:00 – 8:00pm

Part 2 ACCHS webinar series

Access RACGP Aboriginal and Torres Strait Islander Health, Aboriginal Health and Medical Research Council of NSW and NSW Health webinars on issues related to GPs and other health professionals working in the Aboriginal Community Controlled health Services (ACCHS) sector.

SEE WEBPAGE

Topic Webinar Slides
Nicotine Replacement Therapy (NRT) Recording PDF
Hepatitis C epidemiology, screening and treatment Recording PDF
Syphilis: Clinical overview, screening and treatment Recording PDF
Influenza preparedness Recording PDF
715 Health check Recording PDF

National guide webinars

Topic Webinar Slides
The new guidelines: Family abuse and violence (Chapter 16) Recording PDF

 

NACCHO Aboriginal Health and #Smoking : Download the @RACGP Supporting #smokingcessation Guide : Smoking daily is three times as high in the lowest socioeconomic areas of Australia compared to the highest.

“The likelihood of smoking daily is three times as high in the lowest socioeconomic areas of Australia compared to the highest.

What this means is that smoking-related health problems disproportionately affect those least able to afford the medicines that are essential to helping them quit.

We have made massive inroads, now it’s time for the final, decisive push to reduce daily smoking levels.

These medicines work, we just need to do more to help get them into the hands of people who need them most and removing restrictions on prescribing will do just that.”

RACGP President Dr Harry Nespolon said that the Government should act to assist those who struggle to afford the medicines that are proven to help people quit smoking.

Aboriginal and Torres Strait Islander people

 ” Indigenous Australians are still more than twice as likely as non-Indigenous Australians to be current daily smokers.2 However, there has been a progressive decrease in daily smoking rates for Aboriginal and Torres Strait Islander people, declining from 49% in 2002 to 45% in 2008, and then to 41% in 2012–13.3

People who identify as Aboriginal or Torres Strait Islander qualify for PBS authority listing that provides up to two courses per year of nicotine patches, each of a maximum of 12 weeks. Under this listing, participation in a support and counselling program is recommended but not mandatory. Access t nicotine patches for Aboriginal and Torres Strait Islander people can be facilitated through the Closing the Gap PBS co-payment measure (see page 45).”

Extracts from GUIDE

Download the RACGP Supporting smoking cessation: A guide for health professionals (2nd edition) smoking-cessation

Read over 130 Aboriginal Health and Smoking articles published by NACCHO over past 8 years

Read Aboriginal Health and our partnership with RACGP articles published by NACCHO over past 8 years

The Royal Australian College of General Practitioners (RACGP) has today recommended allowing greater flexibility in prescribing for smoking cessation pharmacotherapy.

The bold proposal, contained in the RACGP’s newly released Supporting smoking cessation: A guide for health professionals (2nd edition) (“the guide”), could prove a game-changer for reducing smoking rates.

Pharmacotherapy options available in Australia include nicotine replacement therapy (NRT, e.g. a transdermal patch or acute forms such as an oral spray, gum, inhaler or lozenge), varenicline (a drug that blocks the pleasure and reward response to smoking) and bupropion hydrochloride (which reduces the urge to smoke and helps with nicotine withdrawal).

Oral forms of NRT subsidised on the Pharmaceutical Benefits Scheme (PBS) are gum and lozenges for use as the sole PBS-subsidised therapy. This means that combination NRT (i.e. using two forms of NRT together such as a patch and gum) is not currently PBS-subsidised.

Under PBS rules, a maximum 12 weeks of PBS-subsidised NRT is available per 12-month period.

Australia has made commendable inroads in tobacco control and smoking rates with daily smoking nearly halved from 24% in 1991 to 12.8% in 2013. However, the job is not complete and there has been a slowing in the rate of decline with little change in prevalence from 2013 to 2016 (12.2%).

The latest National Tobacco Strategy aims to reduce the national adult daily smoking rate to 10% of the population and halve the Aboriginal and Torres Strait Islander adult daily smoking rate.

RACGP President Dr Harry Nespolon said that the Government should act to assist those who struggle to afford the medicines that are proven to help people quit smoking.

“Some people can quit unassisted; however, those who take advantage of behavioural support and vital medicines including combination NRT, varenicline and bupropion will substantially increase their chances of quitting.

“The science is in – a host of randomised clinical trials tell us that these medicines work. Varenicline or combination NRT almost triples the odds of quitting and bupropion and NRT alone almost double the odds of quitting versus a placebo at six months. The evidence is also clear that combination NRT is most effective.

“However, as things stand we have fixed PBS rules that don’t reflect best-practice medical assistance. As a result, people trying to quit smoking miss out on PBS subsidies that could make a real difference.

“We need to improve flexibility in prescribing to cut costs for patients using pharmacotherapy so that people who could really benefit from these medicines can access them.

“It’s vital to allow for PBS-subsidised combination NRT, which is proven to be the most effective form of NRT.

“We should also allow GPs to prescribe a second round of PBS-subsidised NRT within a 12-month period because it will help reduce relapse in people who have stopped smoking at the end of a standard course of NRT. This is a public health policy no-brainer, pure and simple.”

Dr Nespolon noted that the inflexibility in PBS prescribing was particularly troubling given that smoking rates are inverse to socioeconomic status.

Chair of the Expert Advisory Group behind the guide, Professor Nicholas Zwar, said that health professionals including GPs should also be encouraged to embrace the “brief intervention” approach to smoking cessation.

“One of the most often cited barriers to providing smoking cessation advice is that it can prove time consuming.

“Up until now health professionals have used a ‘5A’s approach’ which involves identifying patients who smoke, assessing nicotine dependence and barriers to quitting, advising patients to quit, offering assistance and arranging a follow up. It is sound practice but it does take time.”

Professor Zwar said that under the three-step model developed by Quit Victoria, advice and help for patients trying to quit smoking could be easier to provide and more frequently offered by a range of health professionals.

“This three-step model offers patients best practice smoking cessation treatment by linking into multi-session behavioural interventions such as Quitline and encouraging the use of pharmacotherapy.

“It can be summarised as ask, advise and help. Ask and record a patient’s smoking status, advise people who smoke to quit and on the most effective methods for doing so and help them by offering to arrange referral, encourage use of behavioural intervention and the use of evidence-based pharmacotherapy.”

The guide update was funded by VicHealth and the Australian Government Department of Health.

 

NACCHO Aboriginal Health and #Workforce : @uwanews Five Indigenous women doctors graduate from #WA Uni Dr Tamisha King, Dr Adriane Houghton, Dr Heather Kessaris, Dr Kelly Langford, and Dr Shauna Hill

Five Indigenous women were among 206 students to graduate as doctors at a ceremony held last week in The University of Western Australia’s Winthrop Hall.

Tamisha King, Adriane Houghton, Heather Kessaris and Kelly Langford were awarded a Doctor of Medicine and Shauna Hill was awarded a Bachelor of Medicine and Bachelor of Surgery.

Dr King, a Karajarri woman from the Kimberley region, completed her Rural Clinical School placement in Kununurra as well as electives in Melbourne and internship preparation in Broome.

Before enrolling in the MD she completed a Bachelor of Science, majoring in Anatomy and Human Biology, and Aboriginal Health and Wellbeing, winning several academic awards. She was also an active member of the Australian Indigenous Doctors Association (AIDA) and WA Medical Students’ Society (WAMSS) Indigenous Representative in 2016. Dr King will start work as an intern at Royal Perth Hospital next month.

Dr Houghton, a Ngarluma Yindjibarndi woman from Port Hedland, completed UWA’s Aboriginal Orientation Course in 2002 through the School of Indigenous Studies and went on to obtain a Bachelor of Science majoring in Geography. After graduating she worked in labs and chemical analysis for Woodside in Karratha for six years before enrolling in the MD.

Dr Houghton completed her Rural Clinical School placement in Port Hedland and was Rural Health West’s first Aboriginal Ambassador. The single mother with two children aged six and 10 will take up an internship at Royal Perth Hospital next month.

Dr Kessaris, an Alawa and Marra woman from the Northern Territory, completed a Bachelor of Science majoring in Aboriginal Health and Wellbeing and Population Health before enrolling in the MD. Also a member of AIDA, she represented UWA and AIDA at the Pacific Region Indigenous Doctors Congress (PRIDoC) in Hawaii this year and was also a WAMSS Indigenous Representative in 2016.

Originally from Cairns in Queensland, Dr Langford graduated with a Bachelor of Science majoring in Anatomy and Human Biology and Economics before enrolling in the MD. In 2017 she completed her Rural Clinical School placement in Broome. Dr Langford is a Badjala woman from Fraser Island and Darraba woman from Starcke, Cape York.

The same year she also received the 2017 national LIMElight Award for Excellence in Indigenous Health Education Student Leadership for her contribution to the understanding of Indigenous health education to her peers, promoting rural and remote health careers and advocating for improvements to the health of Indigenous people in rural and remote communities. Dr Langford will start her internship at Fiona Stanley Hospital next month.

Dr Hill, a Yamatji-Noongar woman who was born and raised in Perth, completed UWA’s Aboriginal Orientation Course in 2002 and went on to complete a Bachelor of Arts majoring in History and Political science and International Relations. She took up a graduate position in Canberra before returning to Perth to work for an Aboriginal organisation and a research officer at UWA’s Centre for Aboriginal Medical and Dental Health.

Dr Hill then enrolled in the graduate entry Bachelor of Medicine and Bachelor of Surgery, also representing UWA and AIDA at PRIDoC in Hawaii this year. The single mother of three children aged 13, 19 and 20 will take up an internship next month at Royal Perth Hospital.

NACCHO Announcement 2020

After 2,800 Aboriginal Health Alerts over 7 and half years from www.nacchocommunique.com NACCHO media will cease publishing from this site as from 31 December 2019 and resume mid January 2020 with posts from www.naccho.org.au

For historical and research purposes all posts 2012-2019 will remain on www.nacchocommunique.com

Your current email subscription will be automatically transferred to our new Aboriginal Health News Alerts Subscriber service that will offer you the options of Daily , Weekly or Monthly alerts

For further info contact Colin Cowell NACCHO Social Media Media Editor

NACCHO Aboriginal Health and the @HealingOurWay #StolenGeneration : Fact sheets launched by Minister @KenWyattMP have been guided by survivors: they identified the key issues for them with #GPs, #dentists and #agedcare providers, what is helpful and what should be avoided.

“Many Stolen Generations survivors experienced childhood trauma as a result of their forced removal from family, community, culture and language, and sometimes also as a result of abuse and racism experienced after their removal.

Every day events can trigger the original trauma, particularly if a situation brings back the lack of control Stolen Generations survivors experienced when they were taken from their families.”

Interacting with aged care staff, GPs, dentists and other services is often difficult for Stolen Generations survivors said The Healing Foundation’s Chair Professor Steve Larkin

‘General practice is often the first and only point of contact with the healthcare system for many patients. The RACGP has a strong interest in ensuring that general practice services and healthcare in general are safe and responsive to people who experienced the devastating impacts of forced removal,’ he said.

‘This new resource provides essential context and useful tools to assist GPs to identify and understand the impacts of trauma for their patients.

These are principles of good clinical practice, which is beneficial for all patients.’

Associate Professor Peter O’Mara, Chair of RACGP Aboriginal and Torres Strait Islander Health, said the factsheet is a vital resource for GPs.

Download 

Working-with-Stolen-Generations-GP-fact-sheet

Working-with-Stolen-Generations-GP-snapshot

General practitioners, dentists and the aged care sector will be better placed to support Stolen Generations survivors following the launch of new resources at Parliament House .

Download all new resources HERE 

The resources, launched by the Minister for Indigenous Australians The Hon Ken Wyatt AM MP, were developed by The Healing Foundation in collaboration with Stolen Generations survivors and peak bodies including the Royal Australian College of General Practitioners, the Australian Dental Association, Aged & Community Services Australia and the Aged Care Industry Association.

Stolen Generations survivor and member of The Healing Foundation’s Stolen Generations Reference Group Geoff Cooper said he hoped the fact sheets would create greater awareness about the best ways to provide services to the Stolen Generations without triggering trauma.

“Little changes can make a big difference to how we feel when we walk in to a service. Things like not making us talk about bad stuff that’s happened to us if we don’t want to, and explaining what you’re going to do before you do it so we aren’t caught off guard.”

The resources are part of The Healing Foundation’s Action Plan for Healing project, funded by the Department of Prime Minister and Cabinet in 2017 following the 20th anniversary of the 1997 Bringing them Home report, which highlighted the contemporary needs of the Stolen Generations and their descendants.

An Australian Institute of Health and Welfare analysis conducted as part of the Action Plan for Healing project found there are over 17,000 Stolen Generations survivors in Australia today, and by 2023 will all be aged over 50 and eligible for aged care.

“The development of the fact sheets has been guided by Stolen Generations survivors: they identified the key issues encountered when dealing with GPs, dentists and aged care providers, what is helpful and what should be avoided,” Professor Larkin said.

“We’ve been delighted with the level of interest the resources are already receiving from the target sectors, and are excited to see the materials taken up at the practice and provider level nationally.”

Australian Dental Association CEO Damian Mitsch said the organisation was proud to have supported the creation of the dental resource.

“This resource will go a long way in providing education and helpful tips to guide dental practitioners in providing effective dental care to Stolen Generations survivors,” Mr Mitsch said.

Download 

Working-with-Stolen-Generations-Dental-fact-sheet

The CEO of Aged & Community Services Australia (ACSA), Patricia Sparrow, said the organisation and its members were pleased to have contributed to the aged care resource.

“We believe the work of The Healing Foundation in providing information about how aged care services acknowledge the needs, and care for Stolen Generations survivors is critical.

“Through these resources, providers of aged care are able to better understand some of the trauma and triggers as well as the diversity of needs for Stolen Generations survivors, which must be considered in delivering the best quality care for all people,” Ms Sparrow said.

Download

Working-with-Stolen-Generations-Aged-Care-fact-sheet

Resources will now be developed for hospitals, allied health professionals and disability services.

The fact sheets provide practical tips, tailored for each profession, on how staff and management can improve services to Stolen Generations survivors. The suite of fact sheets can be downloaded here.

The Healing Foundation is a national Aboriginal and Torres Strait Islander organisation that partners with communities to address the ongoing trauma caused by actions like the forced removal of children from their families.

NACCHO #HaveYourSayCTG about #closingthegap on Aboriginal and Torres Strait Islander youth health : #NACCHOYouth19 Registrations Close Oct 20 @RACGP Doctor :Routine health assessments co-created with young Aboriginal and Torres Strait Islander people may soon be adopted by general practice.

Part 1 : Research project ‘Developing, implementing, and testing a co-created health assessment for Aboriginal and Torres Strait Islander young people in primary care’

Part 2 : Registrations close 20 October for the NACCHO Youth Conference Darwin 4 November 

Part 3 : If you cannot get to Darwin  you can still have your say about what is needed to make real change in the lives of Aboriginal and Torres Strait Islander youth

‘General practice needs to think more carefully about the issues facing young people as a distinct group. Better understanding has to start with asking Aboriginal and Torres Strait Islander people about important health priorities, and then listening carefully to the responses.

Once we have listened to community voices on health priorities and co-created the young person’s health assessment, we intend to conduct a pilot randomised trial of the new health assessment looking at outcomes including social and emotional wellbeing, detection of psychological distress and appropriate management and referrals.” 

Dr Geoffrey Spurling first had the idea for his research project ‘Developing, implementing, and testing a co-created health assessment for Aboriginal and Torres Strait Islander young people in primary care’ during a moving experience not so long ago, when he attended the funeral of a young Aboriginal woman who had committed suicide. See Part 1

The project was originally published in the RACGP News GP

Read all NACCHO Youth Articles HERE 

Part 1 ‘Developing, implementing, and testing a co-created health assessment for Aboriginal and Torres Strait Islander young people in primary care’. Continued from intro above

‘It was a profoundly sad experience,’ Dr Spurling told newsGP.

‘At the same time, community members were telling me that social and emotional wellbeing, especially for young people, was a health priority.

‘I wanted to do what I could with my medical and research skills to understand and help address the social and emotional wellbeing issues facing the community.’

It was here that his research project began to take shape.

Dr Spurling, a GP at Inala Indigenous Health Service and senior lecturer at the University of Queensland, was recently granted funds from the National Health and Medical Research Council (NHMRC) to develop his project, ‘Developing, implementing, and testing a co-created health assessment for Aboriginal and Torres Strait Islander young people in primary care’.

Through collaboration with Aboriginal and Torres Strait Islander community members, this research aims to develop and implement a health check especially tailored for young people in these communities.

Current Aboriginal and Torres Strait Islander Medicare health assessments involving adolescents are constructed for 5–14-year-olds and 15–54-year-olds. Dr Spurling believes more focus is needed on the health of young people within the second age group, and a specific health assessment should be implemented.

Following development of the tailored health assessments, Dr Spurling and his team intend to conduct a trial comparing the new health check with the current one available in clinical software, aiming to show better detection and management of social and emotional wellbeing concerns.

‘By creating a youth health assessment together with both young people and clinicians, I hope we can have more relevant conversations about health in general practice within both the specific context of the newly developed young person’s Aboriginal and Torres Strait Islander health assessment, and more broadly in general practice.’

The National guide to a preventive health assessment for Aboriginal and Torres Strait Islander people recommends the Social Emotional Wellbeing (SEW) and HEEADSSS screening tools as part of health assessments for young people.

Investigator Grants is the NHMRC’s largest funding scheme, with a 40% allocation from the Medical Research Endowment Account. The scheme’s objective is to support the research of outstanding investigators at all career stages, providing five-year funding security for high-performing researchers through its salary and research support packages. The 2019 Investigator Grants funding totals $365.8 million.

Part 2 NACCHO Youth Conference Darwin 4 November 

 ” Culturally-appropriate care and safety has a vast role to play in improving the health and wellbeing of our people.

In this respect, I want to make special mention of the proven record of the Aboriginal Community Health Organisations in increasing the health and wellbeing of First Peoples by delivering culturally competent care.

I’m pleased to be here at this conference, which aims to make a difference with a simple but sentinel theme of investing in what works, surely a guiding principle for all that we do

Providing strong pointers for this is a new youth report from the Australian Institute of Health and Welfare.

Equipped with this information, we can connect the dots – what is working well and where we need to focus our energies, invest our expertise, so our young people can reap the benefits of better health and wellbeing “

Minister Ken Wyatt launching AIHW Aboriginal and Torres Strait Islander Adolescent and Youth Health and Wellbeing 2018 report at NACCHO Conference 31 October attended by over 500 ACCHO delegates including 75 ACCHO Youth delegates Pictured above 

Read Download Report HERE

The central focus of the NACCHO Youth Conference Healthy youth, healthy future is on building resilience. For thousands of years our Ancestors have shown great resolve thriving on this vast continent.

Young Aboriginal and Torres Strait Islander people, who make up 54% of our population, now look to the example set by generations past and present to navigate ever-changing and complex social and health issues.

Healthy youth, healthy future provides us with opportunities to explore and discuss issues of importance to us, our families and communities, and to take further steps toward becoming tomorrow’s leaders.

We hope to see you there!

Registrations CLOSE 20 October 

Registrations are now open for the 2019 NACCHO Youth Conference, which will be held November 4th in Darwin at the Darwin Convention Centre

REGISTER HERE

Part 3 Have your say about what is needed to make real change in the lives of Aboriginal and Torres Strait Islander youth #HaveYourSay about #closingthegapCTG

Aboriginal and Torres Strait Islander people know what works best for us.

We need to make sure Aboriginal and Torres Strait Islander youth voices are reflected and expertise is recognised in every way at every step on efforts to close the gap in life outcomes between Aboriginal and Torres Strait Islander people and other Australians.’

‘The Coalition of Peaks is leading the face to face discussions, not governments.

The Peaks are asking Aboriginal and Torres Strait Islander youth to tell us what should be included in a new Closing the Gap agreement and we will take this to the negotiating table.’

There is a discussion booklet that has background information on Closing the Gap and sets out what will be talked about in the survey.

The survey will take a little bit of time to complete. It would be great if you can answer all the questions, but you can also just focus on the issues that you care about most.

To help you prepare your answers, you can look at a full copy here

The survey is open to everyone and can be accessed here:

https://www.naccho.org.au/programmes/coalition-of-peaks/have-your-say/

NACCHO Aboriginal Health and #RHD : @RACGP NewGP : ” This should not be the norm for our people ” Dr Olivia O’Donoghue and Pat Turner CEO NACCHO : Ending rheumatic heart disease in Australia

Australia has some of the highest rates of RHD in the world, seen almost exclusively in our Aboriginal and Torres Strait Islander communities,’ Chief Executive of the National Aboriginal Community Controlled Health Organisation (NACCHO), Patricia Turner, told newsGP.

‘A lot of non-Indigenous Australians would have never heard of this disease, yet for our communities, it continues to pose a real and serious threat.

Chief Executive of the National Aboriginal Community Controlled Health Organisation (NACCHO), Patricia Turner, told newsGP.

Article by Amanda Lyons

Read NACCHO RHD articles HERE

Rheumatic heart disease (RHD) is a serious illness, linked to disadvantage and largely preventable – and it’s rife in Australia.

RHD is a cardiac complication of acute rheumatic fever (ARF), an auto-immune illness that is itself caused by group A streptococcal infection (Strep A) which often manifests in sore throat or sores on the skin. It causes lasting damage to the heart, and has an enormous impact on the lives of those who contract it.

‘Our Aboriginal and Torres Strait Islander families are living with generations of occurrences of ARF and RHD, and for some it feels inevitable that it will affect them and their children,’ Dr Olivia O’Donoghue, Lead Aboriginal Health Training Medical Educator and Northern Territory Representative on the RACGP’s Aboriginal and Torres Strait Islander Council, told newsGP.

Read ABC Story : Rheumatic heart disease: Arnhem Land family with three afflicted sons take fight to Canberra

‘RHD and its complications can adversely affect pregnancy outcomes, young people are having major cardiac surgery which should have been preventable, and parents have asked me when their youngest child will need their heart operation as they had recently been diagnosed with ARF.

‘This should not be the norm for our people and something needs to be done to rectify this situation.’

Once ARF has developed into RHD, it requires expensive and complex management involving the coordination of multiple services, including oral healthcare, interventional cardiology and primary care. Patients require regular cardiac monitoring and often surgery.

If ARF is diagnosed in time, RHD can be prevented by bicillin injections; however, this treatment regime is not easy.

‘Regular injections of Bicillin L-A for prophylaxis against RHD are given, three to four times weekly, for an average of 10-plus years, and they are painful,’ Dr O’Donoghue explained.

‘Trying to explain to young children why they need to come in every month for these injections is challenging and heartbreaking.’

Even better than bicillin injections is prevention of ARF in the first place, and work is currently underway by RHD-focused organisation END RHD to create a vaccine against Strep A.

Dr O’Donoghue sees this initiative, and its recent funding boost from the Federal Government, as a positive step, although she would also like to see research into ARF treatment options, as well.

‘The discovery and development of a vaccine against Strep A infection would significantly decrease the burden of disease of ARF and RHD on individuals, families, communities and the health system,’ she said.

‘An interim goal would be the development of an alternative to the three-to-four weekly Bicillin L-A injection which is less burdensome to individuals and those who are administering them.’

Above added by NACCHO : Telethon Kids : Written for kids, by kids from the remote Aboriginal community of Barunga, ‘Boom Boom’ aims to teach children how to prevent deadly rheumatic heart disease (RHD).

Ms Turner is also supportive of the END RHD vaccine work, but wants to see practical, hands-on solutions for those who are suffering in the present.

Pat-Turner-article.jpgCEO of NACCHO, Patricia Turner, believes it is imperative to act decisively on Australia’s high rates of ARF and RHD.

‘A Strep A vaccine would be a game-changer, but developing it will take years and people are dying now – we need to make sure that the really exciting investments in science are coupled with on-the-ground action,’ she said.

Because ARF and RHD have significant links to disadvantage, Dr O’Donoghue believes their elimination will require a focus on the social as well as medical determinants of health – and that this needs to go beyond simple informational campaigns.

‘The onus of prevention should not be put solely on the individual or the family,’ she said. ‘It is not acceptable to say we just need to educate parents and families about personal and household hygiene standards when the surrounding systems make it challenging to provide healthy food choices, clothing, uncrowded dwellings, and to send children to school.

‘There is only so much the health system can do in isolation of improvements in housing, infrastructure and education services, such as access to quality education and services in communities, like supermarkets with affordable fresh produce and cleaning supplies.’

Ms Turner agrees that addressing social determinants of health is critical to ending RHD, outlining some practical requirements she sees as vital in the fight against the disease.

‘We need investment in comprehensive, community-controlled primary care services, so people can get their sore throats and skin sores assessed and treated in order to stop them leading to RHD,’ she said.

‘Regular antibiotic injections reduce the risk of ARF by 80%, but if people can’t get to the clinic or aren’t well-cared for when they get there, we are missing that chance to stop its development.

‘We need to support our clinics to deliver these injections and provide ongoing care for people to live with this lifelong condition.’

Above all, Ms Turner warns that urgent action must be taken now, to guard against poor consequences for the future.

‘Rates of ARF are continuing to rise – by 2031, more than 10,000 Aboriginal and Torres Strait Islander people will develop ARF or RHD,’ she said.

‘Of these people, more than 500 will die, and their medical treatment will cost the health system over $300 million dollars.

‘It’s a no-brainer that we need investment to tackle this disease – no child born in Australia today should die of RHD.