NACCHO:Real stories of real people who are working to deliver better health outcomes for Aboriginal people.
This is Richard’s first blog on his new site
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In work I am CEO of the Aboriginal and Torres Strait Islander Healing Foundation and have been a CEO in Aboriginal & Torres Strait Islander organisations since August 2000.
I was CEO of Maari Ma Health based in Broken Hill NSW for 8 years; I went from there to Brisbane to take up the CEO role with the Aboriginal and Torres Strait Islander Community Health Service (ATSICHS) for 14 months and then to my current role with the Healing Foundation where I have been since September 2010.
I moved to Broken Hill in 1996 with my partner and our two sons (who were 2yrs & 6 months old respectively). I had no job there and set about looking for work on arrival. I soon had the choice of taking a job with a fledgling Aboriginal Health Service (I would be their third employee) or a much safer job with Social Security which was later to become Centrelink under the Howard government
I chose the former which was a Project Officer gig with the Far West Ward Aboriginal Health Service (later to become Maari Ma) on a CES TAP* scheme for 2 years.
It’s been a great ride and I have experienced much of the good and bad sides of human nature along the way. I have helped build success in organisations. I have been on the blunt end of black politics and I have gained insight into what makes Indigenous organisations successful. I don’t hold grudges towards anyone across this journey, you get bruised along the way; it’s the nature of the space.
I have to say though that I have had more uplifting experiences on my journey than low points. On the whole I have enjoyed the ride. I have had the opportunity to work with good people both black and white who wanted to bring tangible improvement to the lives of Aboriginal and Torres Strait Islander people.
It’s the journey I want to share on this blog. I want to provide you with a firsthand account of working at the coal face of Aboriginal and Torres Strait Islander affairs from a management and leadership perspective.
It’s a challenging space to work in because it is so political. On the other hand it has been very satisfying because of the people relationships that I’ve developed and the things that we’ve achieved. One outstanding element of my journey has been the sense of humour that exists in our Aboriginal and Torres Strait Islander communities. How our people maintain a positive and humorous take on life in spite of high death rates, high levels of trauma, grief and loss in our communities, violence, alcohol abuse, chronic disease – the list seems endless – is a wonder. It never ceases to amaze.
The Aboriginal Health Service was small (it commenced life with $35k in the bank). The inaugural CEO was William ‘Smiley’ Johnstone, who had been a railway fettler and who had tried his hand at becoming a teacher, gone into the politics of ATSIC and became CEO of the new Aboriginal health service. I had little knowledge of the health system but I had solid administration experience and had worked in HR in WA as an employment and development officer and cross cultural trainer. These jobs were in federal and state bureaucracies.
Those early days of the mid-1990s were challenging. We were confronted with a health system that employed few Aboriginal people, and those that were in the system worked at the margins and had little training. The public health system in NSW had undergone a restructure to create 17 Area Health Services and Boards, including the Far West Area Health Service, which mirrored the Murdi Paaki ATSIC region boundary. Aboriginal health was a poorly grasped concept to the health system and even more foreign was the concept of actually involving Aboriginal people in planning, designing and delivering health services that affected them.
In addition to this the Murdi Paaki Region of NSW had the poorest health outcomes in NSW. The whitefellas were worse off than their counterparts in the rest of NSW, but when we looked at data for Aboriginal people, the story was much worse. On almost every indicator of health (and for that matter education, employment, housing and economic development) Aboriginal people fared far worse than Aboriginal people in the rest of the state.
Even more alarming than the actual health status of the region was that the data told us that most Aboriginal people were hospitalised from complications arising from chronic diseases, like diabetes and respiratory conditions. These are preventable diseases. Many people were being diagnosed with their chronic illness on presentation to hospital, which often meant the disease was well advanced with little chance of cure. That’s the problem with chronic illness, you can have a problem but not feel sick, and by the time you are aware you have an issue it may be too late.
The health system needed to change to engage with Aboriginal people more effectively to catch chronic conditions earlier in their onset and Aboriginal people needed to be involved in how this reform would occur, to better meet the needs of their own people. The unrelenting nature of a number of socio-economic factors makes it difficult for our people to prioritise health above other pressing day to day issues, like surviving on welfare or CDEP**.
The next challenge was that our communities (9 in all) were spread out over an area that geographically was one sixth the total area of NSW. This made service delivery, particularly continuity and quality of care, very challenging.
Along with our organisation and the public health system the other key players were the Flying Doctors (South East Section) and the Rural Health Training Unit. The Flying Doctors did a great job of providing emergency care but did little on the primary health care (prevention / early intervention) front for Aboriginal people, other than GP clinics in communities that were not well coordinated with the rest of the system. The Rural Health Training Unit was another fledgling organisation that would play a key role in improving the system for Aboriginal people.
So here I was living in Barkantji country with a young family, working for an organisation that was to deliver better access to health in a challenging landscape, with no experience working in the health system.
In my next blog I’ll share with you the vision that was developed by Aboriginal people that captured our imaginations and the partnership that developed between whitefellas and blackfellas to reform the health system in the Murdi Paaki Region.
You can find out more about Maari Ma and what it is currently doing by visiting: www.maarima.com.au
* CES TAP scheme – Commonwealth Employment Service Training for Aboriginal People
**CDEP – Community Development Employment Program, work for the dole scheme that was in place for Aboriginal people long before it was mandated for long term unemployed.
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