NACCHO Aboriginal Health @IndigMaraProjct : 10 Indigenous runners #RunSweatInspire to finish the #NewYorkMarathon

 “I’m hoping to show other Aboriginal and Torres Strait islanders that anything is possible when you put in the hard work

I joined a walking to running program and this is a great example of what you can achieve out of something as small as that.

Growing up I wasn’t a sport person but it’s not all about sport, it’s about a holistic view and making a change for the better, I want people to think ‘if Cara can do it than so can I’.”

Queanbeyan mother Cara Smith has just completed a remarkable journey at the New York marathon on Sunday (see her Story Part 2 below )

“The running the New York Marathon  has given me a lot of discipline.

The main reason why I joined the squad was to be a positive role model for my family and for my community. People see me doing this and hopefully it gets them on the right; if you put in hard work you get rewarded for it.”

Speaking from Central Park New York Roy Tilmouth said the IMF running project had inspired him to be a positive role model for his community in Alice Springs.(see story Part 1 Below )

Update 9.00 am good news all 10 completed #NYM

Background news coverage Part 1 of 2

GROUP of indigenous Australians planning to participate in this weekend’s New York City marathon say the terror attack in Manhattan will not deter them from the race.Indigenous Marathon Foundation director Rob de Castella said the squad never considered pulling out.

“Absolutely not – I refuse to change my way of life and my aspirations and dreams based on what some radical, rat bag people do because once you start doing that, then terrorism wins,” he said.

The IMF project turns indigenous Australians from beginners to marathon runners within six months in an effort to promote healthy lifestyle choices, resilience and success.

“Most of them have done no running and they’ve gone from struggling to run three kilometers or five kilometers to six months later running 42 kilometers non-stop,” he said.

Participants also have to complete an education component, which this year featured an Aboriginal and Torres Strait Islander Mental Health and First Aid course.

De Castella said the runners, many from remote and regional areas, have experienced profound transformations as a result of the program.

“They realize that they’re so much stronger than what they were,” he said. “They want to make life better for their community because they are exposed to so much dysfunction and suicide, loss, suffering, abuse and alcoholism and they want it to stop.

“They realize that it has to start with them so this experience transforms them and makes them realize they are strong and that they have the capacity to drive change and address those issues they want stopped,” he said.

Twelve indigenous Australians will run in the world-famous New York City marathon, thanks to de Castella’s mentoring program. In the lead up to the marathon, the participants had to complete several challenges, including a 30-kilometere run in Alice Springs.

Speaking to News Corp Australia in Central Park before a practice run, Roy Tilmouth said the IMF running project had inspired him to be a positive role model for his community in Alice Springs.

“The running has given me a lot of discipline,” he said.

“The main reason why I joined the squad was to be a positive role model for my family and for my community. People see me doing this and hopefully it gets them on the right; if you put in hard work you get rewarded for it.”

Another mentee of De Castella, Layne Brown, said that his daughter had inspired him to prove something to himself.

“I’ve lost 20 kilos on this journey and I’m trying to live a better way than I have in the past,” he said.

“I stuffed a lot of things up and I want to be a better person and keep working towards that and running has been my vehicle for that over last six months”.

For Perth’s Luke Reidy, the running project offered an avenue to tackle his depression.

“I had a few deaths in the family and got depressed and I just want to highlight how physical exercise can also help with mental exercise,” he said.

Mr Reidy said he was humbled by the amount of people who had followed his progress and given their support throughout the process.

“The amount of people that watch your journey that you don’t know and they come up to you – it’s really humbling.”

Queanbeyan mother Cara Smith will complete a remarkable journey at the New York marathon on Sunday. Photo: Rohan Thomson

Smith has been part of a gruelling six-month training program under the tutelage of Australian marathon legend Rob de Castella as part of the Indigenous Marathon Foundation.

The 30-year-old was one of 12 people selected from more than 150 applicants after sharing her story with de Castella of wanting to fight a long family history of diabetes and obesity.

Smith has braved 4am training sessions in the the Canberra winter said she has herself through it to be part of something special and inspire her one-year-old son.

Smith said she was couldn’t wait to arrive in New York and soak up the atmosphere ahead of one of the biggest challenges of her life.

“I’ve been looking forward to this all year, I’m super excited and really nervous too so it’s a good mix but I just want to get started,” Smith said.

“I don’t know what to expect but I just want to soak up atmosphere and I can’t wait see my son’s face when I show him the New York marathon medal and talk to him about it one day.”

There will be unprecedented security at the event following the recent terrorist attack in New York which claimed six lives.

Smith prepared with five training camps which included a 30km effort in Alice Springs last month, the longest the group have run in preparation for the 42km epic.

“The final 12km will be pure willpower, I have a strong purpose and that is my son and setting up a healthy active lifestyle for him to aspire to,” Smith said.

“I want to set an example and I’ve done the training so I’m confident I’ll get there, I know it’s going to be tough but I’m really looking forward to the challenge.

“I want to see what the infamous wall throws at me, I’m really pumped for the final hurdle and I just hope the body and mind will hold up.”

De Castella said Smith’s sense of purpose is what will carry her the final 12km when her body is screaming to stop.

“In the marathon you always get to a point when you ask yourself ‘why am I doing this’ and it’s really important to have a really strong answer to that question,” de Castella said.

“The marathon doesn’t start until 30 km and that’s as far as they’ve ever run so they just have to get themselves to starting line and then it’s about hitting the wall and pushing through soreness and fatigue and blisters and exhaustion and pain.

“The only reason you keep going because is the reason of why you’re doing it and Cara’s reason is she wants to be a great model for her child and a leader for the community.

“These are everyday people, mums and dads and single parents, they’re not elite athletes, not high-flying academics and doctors and lawyers, they’re just everyday people that have basically had a gutful of all of the struggles and the problems in life and they just want to be part of a change going forward.”

Smith hopes her performance will inspire those in the indigenous community who are looking to make positive changes in their lives.

“I’m hoping to show other aboriginal and Torres Strait islanders that anything is possible when you put in the hard work,” Smith said.

“I joined a walking to running program and this is a great example of what you can achieve out of something as small as that.

“Growing up I wasn’t a sport person but it’s not all about sport, it’s about a holistic view and making a change for the better, I want people to think ‘if Cara can do it than so can I’.”

Press release from Federal Government

 

 

Aboriginal Maternity Health Program : #CATSINaM17 @IUIH_ Million-dollar boost for groundbreaking #Indigenous maternity program

“It is informed by Indigenous knowledge and community control with a redesigned health service to provide 24/7 continuity of midwifery care and birthing in an Indigenous birth centre,

“With Indigenous leadership and a team with expertise in Indigenous health and research we can translate what we know works in other settings, and other countries, into practice here in Australia.”

Institute for Urban Indigenous Health CEO Adrian Carson said a key component of the project was the Indigenous control and governance of services.

A maternity program designed to achieve better health outcomes for Aboriginal and Torres Strait Islander women and their babies has received a $1.1 million grant from the National Health and Medical Research Council (NHMRC).

The project, led by The University of Queensland’s Professor Sue Kildea and researchers from the University of Sydney and the Institute for Urban Indigenous Health, will implement Birthing on Country on a number of sites with a view to an Australia-wide roll out.

The NHMRC grant will help determine the sustainability of a Birthing on Country service model in each community, along with the impact on Aboriginal and Torres Strait Islander women, their communities and health services.

“The Birthing On Country program has a strong emphasis on culturally and clinically safe care, strengthened support for families, growing a culturally capable workforce and the Indigenous maternal and infant workforce,” Professor Kildea said.

“This program focuses on the year before and the year after birth, as the most important time in life.

“It also allows us to review the effect on three of the most costly health outcomes across the lifespan for Aboriginal and Torres Strait Islander peoples: preterm birth, low birth weight and hospital admissions in the first year of life.”

Professor Kildea said the project team was calling on all Australian governments and health organisations to work with them to implement Birthing On Country programs.

“After two decades of research, including consultation with Indigenous elders and communities, we can now enact State and Federal health policy and put into practice national and international evidence of the safety, benefits and cost-effectiveness of culturally safe care,” she said.

“With Indigenous leadership and a team with a wealth of cross-disciplinary expertise in Indigenous and health services, we can translate what we know works in other settings and other countries into practice here in Australia.”

The project, entitled ‘Building on Our Strengths (BOOSt): Developing and Evaluating Birthing On Country Primary Maternity Units’, also includes the Aboriginal and Torres Strait Islander Community Health Service (ATSICHS) Brisbane, the Waminda South Coast Women’s Health and Welfare Aboriginal Corporation, the Australian College of Midwives, the Congress of Aboriginal and Torres Strait Islander Nurses and Midwives, and the Rhodanthe Lipsett Indigenous Midwifery Charitable Fund.

The NHMRC grant builds on previous funding from the Ian Potter Foundation in Melbourne, the Institute for Urban Indigenous Health, ATSICHS Brisbane, the Mater Health Service, Queensland Health and an earlier NHMRC grant.

 

Aboriginal Health and Children in detention #NTCOSS2017 Speech @NTRoyalComm Mick Gooda reports ” What children have told us “

 

” There is a strong perception that that the system of detention in the Northern Territory is failing. It is failing our young people, it is failing those who work in the system and it is also failing the people of the Northern Territory who are entitled to live in safer communities.

We have heard that where detention systems are effective they are smaller centres with a therapeutic focus.

An approach that is appropriately child centred for children and young people, who at this critical time of their development, including their brain development, are not mini adults and should not be treated as such.

If a child must be removed then they must be provided with the care, support and stability that any child is undeniably entitled. “

Speech to the NT Council of Social Service 26 September 2017 Commissioner Mick Gooda see in full Part 2 Below

Read over 48 NACCHO articles NT Royal Commission #Dondale

 ” Yesterday we published a booklet which gives voice to the children who have experienced the child protection system – they have told us their stories either in evidence or by way of recorded story.

When we asked one boy  about what he had experienced and we asked him if there was any place out there that would be suitable for you to be placed into care?

He simply told us I only want to be with my Mother “

Download ” What children told us -Child protection  It’s time our children’s voices were properly heard.”

voices-what-children-have-told-us

Part 1 SNAICC calls for a response to the voices of children in the Northern Territory

SNAICC welcomes the recent report from the Royal Commission into the Protection and Detention of Children in the Northern Territory for its ability to promote the voices of children and young people affected by a child protection system that is in crisis, which, vitally, provides an insight into the real impact of ongoing failures of government to appropriately respond to children in need.

The report, Voices: What children have told us – Child Protection, captures what is often lost in discussions about the best interests of our children – the voices of our children.

What these powerful stories demonstrate is a pattern of denial of basic rights, ongoing policy and practice failures from successive NT governments, and – bluntly – an uncaring approach to caring for our most vulnerable children.

Aboriginal and Torres Strait Islander children make up 89.1 per cent of all children in out-of-home care in the Northern Territory. This is completely unacceptable.

The experiences courageously shared by children and young people interviewed by the Royal Commission further evidence the extensive reform that is required in the NT child protection system, echoing recommendations from SNAICC’s submission to the Royal Commission submitted in February 2017.

This is the time for genuine partnership between Aboriginal and Torres Strait Islander communities and the Federal and Northern Territory Governments.

We are hopeful that the voices captured in this report go someway to inspire an authentic response to the calls of children to create a new system that enables them to thrive, replacing the current system that perpetuates harm.

Part 2 Speech to the NT Council of Social Service 26 September 2017 Commissioner Mick Gooda

Thanks for that nice introduction Wendy and really thanks for making time for us to come along today and talk to NTCOSS about the Royal Commission.

We are now entering the phase leading into the handover of the report when a lot of work is coming together and gelling towards a set of recommendations that we hope will change the whole nature of how we treat children in the Northern Territory and hopefully like Wendy said show the way for the rest of Australia.

I acknowledge the Larrakia people the traditional owners of this place we now call Darwin, both personally as a Gangulu fella from Central Queensland and on behalf of the Royal Commission for making us welcome to base our work on your country.

I wasn’t here for the Welcome to Country but I saw the young ladies outside and isn’t it great to see the young people do a Welcome to Country.

It is a handing over of that particular ceremony, and I was reminded of a tweet the other day about the only thing we do in Australia that represents any cultural aspect of Australian culture is the Welcome to Country.

And I thought about that and again it shows that if we pay respects to Aboriginal people we pay respects to everyone in Australia.

I’d like to think of Australian culture as being a bit more than football, meat pies and Holden cars.

Like I said we are about eight weeks away from our reporting date of the 17th November and it is time for us to bring people together to talk about how we have done our work as a Royal Commission.

The first thing we found is that our Royal Commission isn’t remarkable.

There have been more than 50 inquiries, reports and reviews on issues of child protection and detention that go to the things we’re looking at.

Commissioner White and I understand that people are cynical and fatigued.

They told us that in pretty clear and unambiguous terms.

Once again another Inquiry had arrived to look at issues of long standing when the overwhelming experience of other inquiries had only seen the situation worsen.

Yet this community has continued to provide us with information, to attend community consultations, community forums and meetings.

During our time we have witnessed a tremendous desire of people not only to ensure that there is reform, but also as communities to accept responsibility for ensuring the safety of our children.

Commissioner White and I were taken aback when we had a meeting with the full Councils of the Northern Land Council and the Central Land Council where half of our time was taken up by communities getting up and saying we’ve got to stop blaming government, we’ve got to start taking responsibility for what we have contributed to as parents.

And that tells me that there is a great appetite within the Aboriginal community for change and to take responsibility.

As we head to that 17th November deadline we are focused on presenting a pathway for children, families and communities across the Northern Territory.

A plan – with a big caveat – if implemented, that will deliver the necessary widespread reform and change for which Territorians have waited for so long.

Since the Commission was established we have:

  • held three months of public hearings in Darwin and Alice Springs covering both youth detention and child protection
  • heard from over 210 witnesses
  • received more than 480 witness statements and more than 430 personal stories
  • received over 250 submissions
  • taken site visits to detention centres
  • visited and engaged with communities including via our community engagement team
  • held open and private forums and meetings including with victims of crime, youth justice officers, police officers, foster carers, care and protection workers, organisations and peak bodies.
  • heard hundreds of stories from children, families and communities who have had firsthand experience of child protection and detention in the Northern Territory.

Commissioner White and I thank everyone who has provided information to us because without this we would not have been able to fully investigate and ultimately to formulate our recommendations.

We have to make particular mention of those children and young people who have had experiences of the youth detention and child protection systems who have courageously shared their experiences with us.

Their evidence, and that of their families, frontline workers and worker and others involved in the system, has at times been very confronting.

I think this Commission has changed all of us.

I was talking to Tony McEvoy our first Aboriginal QC the other day and he told me of a recent experience where just the issue of child protection in another jurisdiction just made him tear up at the memories of what we went through up here, people like us, imagine the young people inside that system.

So we’re committed to ensuring that their voices are heard throughout our report.

Earlier this year we published a booklet which set out what we were told by communities when we met with them last year.

Yesterday we published a booklet which gives voice to the children who have experienced the child protection system – they have told us their stories either in evidence or by way of recorded story.

This booklet is available on the ( NACCHO )  website.

Please feel free to distribute it far and wide.

It’s time our children’s voices were properly heard.

It comes as no surprise that one of the first things we say is that the detention and child protection systems appear to be broken

    • Chief Minister Gunner has publicly acknowledged that the systems are broken
    • Those in the frontline – current and former youth justice, case workers, foster carers, lawyers, judiciary, representatives and agencies and government past and present – as well as the children, families and communities impacted, have told us detention and child protection in the NT is failing.
    • In our Interim Report in March we said –

“There is a strong perception that that the system of detention in the Northern Territory is failing. It is failing our young people, it is failing those who work in the system and it is also failing the people of the Northern Territory who are entitled to live in safer communities”

All the evidence we have received indicates that locking children up in Don Dale like conditions does not lead to good outcomes.

It doesn’t rehabilitate young people, it doesn’t reduce recidivism and it does not make our community safer.

What we have seen is that if you pursue a punitive based approach, these goals of rehabilitation, of reducing recidivism and safer communities, are likely to be unattainable.

What we have also found is that we cannot fix the problems within detention centres if we don’t fix the pathways into those places.

What we have heard is that many young people can be diverted from this ‘inevitable path’ through changes to legal processes, early intervention and more young people going into diversion programs when they first encounter the youth justice system.

Not surprisingly the first contact a young person has with the justice system is generally with the police and is one of the first opportunities to set them on the right path.

We have heard that if their initial contact with police is handled appropriately, the young person can be guided towards rehabilitation rather than towards a detention centre.

That doesn’t mean a go easy approach – what it does mean though is recognising that the chance is there at an early stage to change the course of a young person’s life for good.

For the small number of children who will need to be kept in secure detention, we have heard about very different models to those which currently operate in the NT.

Experts here in Australia and overseas have told the Commission that purely punitive approaches are no longer effective nor successful in managing young offenders.

Further, we have heard that where detention systems are effective they are smaller centres with a therapeutic focus.

An approach that is appropriately child centred for children and young people, who at this critical time of their development, including their brain development, are not mini adults and should not be treated as such.

Commissioner White and I have said before that we will not be recommending to the Northern Territory Government that they build another big detention centre.

For the small number of children who require secure detention a different approach is needed – with education and training at its core, that provides well-resourced health and wellbeing programs for the children, so that when they do re-enter the community they are more likely not to reoffend.

Just as a new approach is needed for youth justice and detention what we have heard during the Commission about the child protection system in the Northern Territory also signals the need for a paradigm change.

The Commission has heard much evidence from those with experience of the child protection or welfare system – both personally and professionally.

From the children and families we have heard about the impacts of separation from culture, family and kin, resulting from the placement of children into care.

DF – one of our Vulnerable Witnesses – as a matter of fact the last witness to this Royal Commission – told us in out last public hearing he and his siblings were placed into care when he was the age of 10.

At the time he was removed he understood he would be placed into respite care for just two weeks – he was told it would be just enough time for his Mum to get a house and make some arrangements.

He described the heartbreak at the prospect of being separated from his Mum for two weeks. He didn’t know at the time but it would be much longer.

DF told us that some months after going into respite he found a ‘care order’ in his foster carer’s house. He said he took it into his room and read it.

It was the first time that he understood that he wouldn’t be going back to his mum any time soon. The order placed him into protection until the age of 18.

He told us that no one had bothered to speak to him, not his carer, not his case worker, not anyone. He found out about this life changing decision accidentally.

Not surprisingly, he absconded from care many times, he was reported to police just a many times.

So the system that was set up to protect him actually facilitated his entry into the youth justice system.

When we spoke to him about what he had experienced and we asked him if there was any place out there that would be suitable for you to be placed into care?

He simply told us I only want to be with my Mother.

Challenges in communication, with multiple placements, changes in foster and respite care arrangements, separation from families, interruption to education and a lack of continuity of case management are just some of the issues we have heard.

We have heard also of experiences which suggest that the placement into care has delivered poorer outcomes than if a child had remained within their community and within their family.

We also heard of cases where we were told that a child, in the care of the CEO, was in need of care.

If a child must be removed then they must be provided with the care, support and stability that any child is undeniably entitled.

We know that those who enter the child protection system have a higher chance of ending in the detention system – we call them the ‘Cross Over’ kids.

This speaks to the need for early intervention and to seek to close off that seemingly inevitable pathway.

Our goal should be to help prevent children entering protection by having greater capacity to identify the triggers that indicate a family is in need, that needs support early and well before the statutory system intervenes.

It is the early actions which will have the greatest impact for them and their communities.

For example, it has been found that pathways into juvenile justice can often stem from childhood trauma that remains unaddressed.

There are huge demands on child protection systems across Australia and too often children end up languishing in such systems and any assistance is provided too late.

And successive inquiries have repeatedly found that child protection systems are based on out of date assumptions yet we have failed to see reform efforts that are based on an understanding of the scale of child abuse and neglect.

We have had experts analyse the Niland Report Inquiry and they tell us the kids that were screened out for intervention in that State mostly me the benchmark for intervention.

We are also told that it is easy to translate those figures to the Northern Territory.

From our perspective that means that there is this great wave of children out there and families out there in dire need of support.

And the statutory child protection system, no matter how good you make it, won’t be able to cope.

The emphasis on early intervention and early support will be the cornerstone of our recommendations.

The goal for us all must be a system that is child focused, community involved, evidence based, locally tailored and providing support for children and families as early possible.

It is fitting I close with what a couple of stories from children and I’ll go to the second one first.

And they are positive stories and I think we have to be positive.

Commissioner White and I decided early in this Commission that if we can’t think positively about the future of children we should resign and let someone else do this job.

Because we have got to remain positive because if we don’t remain positive then I think it is all lost.

In all the negative stories we got told about child protection one young woman described her case worker taker her out to lunch and talking with her for about an hour.

This was apparently such an unusual occurrence for this young woman that it stuck in her mind for years.

Commissioner White and I made a habit of ensuring that we ask every vulnerable witness who came before us, particularly in the youth detention system, were there any good guards?

Were there any good youth workers?

Because we had heard plenty abut the negative youth workers.

And every one of those children said of course there were good youth justice workers and they were in the majority.

And then we asked a follow up question – what made a good youth justice worker?

And every one said the same thing.

They spoke to us, they treated us like humans.

And what does that tell us about the needs and wants of young people?

They just want people to talk to them and treat them like humans.

I have to end by acknowledging the work of the hundreds of people and organisations – many represented here today – who have contributed to the work we are undertaking.

Like I said we received more than 320 submissions from individuals, community organisations, peak bodies, academics, government, non-government and other organisations.

In the face of the challenges that children and young people confront in the NT, this is so encouraging and shows Commissioner White and I that there are so many people willing to work towards change and improvements in the system.

And indeed put the kids of the Northern Territory in the centre of all of our considerations.

Thank you Ladies and Gentlemen

NACCHO Aboriginal Health #Strokeweek : #Fightstroke Aboriginal people are up to three times more likely to suffer a stroke than non-Indigenous

 

” Aboriginal and Torres Strait Islander people are up to three times more likely to suffer a stroke than non-Indigenous Australians and almost twice as likely to die, according to the Australian Bureau of Statistics. It’s an alarming figure and one that  prompted the National Stroke Foundation in 2016 to urge the Federal Government to fund a critical $44 million awareness campaign in a bid to close the gap .

The good news is most strokes are preventable and treatable.

However communities need to be empowered to protect themselves from this insidious disease.”

Sharon McGowan, Stroke Foundation CEO ( see full Aboriginal Stroke statistics part 2 below

Download the 48 Page support guide :

journeyafterstroke_indigenous_0

Read over 75 Stroke related articles published by NACCHO over past 5 years

“Never had I ever come across one ( stroke ) or heard much about them. I had nothing to do with them,”

When I woke up, I didn’t know what was going on. I couldn’t communicate. I couldn’t tell anyone I was still here. It was really scary. I’d never seen the effects of a stroke.

First, I lost my voice, then my vision, my [ability to] swallow and my movement of all my body parts. I lost all my bowel and bladder function. I’ve still got bad sight but I can see again. My speech took about six months.

With help from the Aboriginal Disability Network, they advocated to get me out and get the right support equipment at home “

For Tania Lewis, an Awabakal woman, stroke was something that only happened to older people. But in 2011, Tania suffered a severe stroke at the age of 39 that would leave her with permanent right-sided hemiplegia – paralysis of one side of the body.

Pictured above : Editor of NACCHO Communique and Stroke Foundation Consumer Council Board Member Colin Cowell (left ) with fellow stroke survivor Tania Lewis at an NDIS workshop in Coffs Harbour conducted by Joe Archibald (right )

Part 1 Stroke Foundation in 2016 called on government to close the gap

Originally published here

A stroke occurs when supply of blood to the brain is disturbed suddenly. The longer it remains untreated, the heightened the risk of stroke-related brain damage.

Medical treatment during the first onset of symptoms can significantly improve a sufferer’s chance of survival and of successful rehabilitation.

In Australia, stroke is the leading cause of long-term disability in adults, accounting for 25 per cent of all chronic disability. The NSF reports that roughly 50,000 strokes occur per year with over 437,000 people living with stroke across the country. While severity varies, two thirds of victims, like Tania, are left with impeding disabilities

But in 2011, Tania suffered a severe stroke at the age of 39 that would leave her with permanent right-sided hemiplegia – paralysis of one side of the body.

The burden of stroke doesn’t just fall on the patient, but can take a significant toll on family and carers.

“The doctor at the hospital tried to take Power of Attorney and Guardianship away from me and give it to the Guardianship Board, because he didn’t believe that [my husband] Len or anyone could look after me,” Tania recalls.

“I was put through hell. I figured life wasn’t worth living anymore because they took everything away from me. I couldn’t go home to my family. So I tried to off myself.

“Then all of a sudden, one day the doctor said, ‘You can go home. We can’t rehabilitate you anymore’. At home, I was having seizures for a while. My hubby wouldn’t sleep. He and his mum would take shifts looking after me. We tried to get assistance but there was nothing for young people. So one day, my husband collapsed on the lounge room floor from exhaustion. It was just a nightmare. That’s how I ended up in aged care.”

Tania spent the next two and a half years between three aged care facilities.

“I wouldn’t wish it upon nobody,” she says.

It was during her nightly ritual of chatting with her daughter via Facebook that Tania typed “young people in nursing homes” into Google. The search engine’s results would lead to her life-changing encounter with the YPINH.

“With help from the Aboriginal Disability Network, they advocated to get me out and get the right support equipment at home. Whatever I need, physio, OT – they’ve got my back. I can’t thank them enough for what they’ve done for me.”

Today, Tania is working with the Aboriginal Disability Network, helping Indigenous Australians navigate their way through the National Healthcare System.

It has long been recognised that Aboriginal and Torres Strait Islander people have a life expectancy that is approximately 20 years less than non-Indigenous Australians (Australian Bureau of Statistics). Recent data from the ABS shows that up to 80 per cent of the mortality gap can be attributed to chronic diseases such as heart disease, stroke, diabetes and kidney disease.

For many Aboriginal communities, especially those in remote regions, socio-economic factors play an important role. Kerin O’Dea from Darwin’s Menzies School of Health Research cites unemployment, poor education outcomes and limited access to fresh foods as key factors in her paper, Preventable chronic diseases among Indigenous Australians.

Lifestyle related risks such as smoking, alcohol misuse, stress, poor diet, and inadequate physical activity also need to be addressed, according to the Australian Institute of Health and Welfare .

But the first step, McGowan says, is for indigenous stroke sufferers to recognise the signs of a stroke in themselves and their family members. The NSF recommends the F.A.S.T. test as the most effective way to remember the most common signs of a stroke.

Face: Check their face. Has their mouth drooped?
Arms: Can they lift both arms?
Speech: Is their speech slurred? Do they understand you?
Time: Is critical. If you see any of these signs call 000 straight away.

“If I had known that because I’d lost my vision I had suffered a stroke, I could’ve put two and two together and got help, but I didn’t know anything,” Tania says.

“I was a heavy smoker, but not anymore – no way. Life’s too important. I didn’t ever know anything about a stroke – I was more thinking when you smoke, you can have lung problems and lose your fingers, like on the packets. But they don’t say anything about a stroke – they don’t advertise that stuff.”

The Stroke Foundation called on the Federal Government to fund an urgent $44 million campaign to address the gap in stroke care. For more information on stroke and the campaign, visit strokefoundation.com.au.

Part 2 Aboriginal Stroke Facts

From here

  • The incidence rate of stroke for Aboriginal and Torres Strait Islander Australians has been found to be 2.6 times higher for men and 3.0 for women (Australian Institute of Health and Welfare, 2008; Katzenellenbogan et al. 2010) compared to non-Aboriginal and Torres Strait Islander Australians and many suggest that these figures may in fact be underestimates (Thrift et al 2011).
  • Aboriginal and Torres Strait Islander Australians are known to experience stroke at a younger age than their non-Aboriginal and Torres Strait Islander counterparts, (Katzenellenbogen et al., 2010; Australian Institute of Health and Welfare, 2004) with 60% of Aboriginal and Torres Strait Islander non-fatal stroke burden occurring in the 25-54 year age-group compared to 24% in the non-Aboriginal and Torres Strait Islander group (Katzenellenbogen et al., 2010).
  • The prevalence of stroke is similarly significantly higher at younger ages among Aboriginal and Torres Strait Islander people (Katzenellenbogen 2013), with a significantly higher prevalence of co-morbidities among Aboriginal and Torres Strait Islander patients under 70 years of age, including heart failure, atrial fibrillation, chronic rheumatic heart disease, ischaemic heart disease, diabetes and chronic kidney disease. This reflects the increased clinical complexity among Aboriginal and Torres Strait Islander stroke patients compared with non-Aboriginal/Torres Strait Islander patients.
  • Aboriginal and Torres Strait Islander stroke patients aged 18–64 years have a threefold chance of dying or being dependent at discharge compared to non-Aboriginal and Torres Strait Islander patients (Kilkenny et al., 2012).

Aboriginal #Health #Research debate : Controlled experiments won’t tell us which #Indigenous health programs are working

 ” For example, it is known anecdotally in Alice Springs that some Aboriginal Australians who could benefit from kidney dialysis treatment prefer, instead, to go back to their community to be on country.

While this can be detrimental to their physical health, it has important cultural significance for them.

The RCT approach in this situation would undoubtedly demonstrate the health benefits of kidney dialysis. But understanding this problem in the context of real lives requires different methodologies.

Unless we design research programs to consider why people would rather stay on country than receive effective health treatments, Aboriginal health may not improve.

From the Conversation August 2017

Picture above Some Aboriginal Australians who could benefit from kidney dialysis treatment prefer to go back to their community to be on country instead. WESTERN DESERT/AAP

Read over 40 NACCHO Research posts published over the past 5 years

Described as “one of the simplest, most powerful and revolutionary tools of research”, the randomised controlled trial (RCT) has yielded a great deal of important information in the health sciences. It is usually held up as the “gold standard” for gathering medical evidence.

The RCT can tell us which procedure or treatment is more effective under tightly controlled situations. This evidence is useful and important, but we also need to know things like what people want from health services, which treatments are preferred, and why some people stick to treatment regimes and some people don’t.

These issues are particularly relevant to remote Australia and Aboriginal and Torres Strait Islander health, where high levels of illness and early death persist, and where what applies to the tightly controlled conditions of a laboratory rarely translates.


Read more: Why are Aboriginal children still dying from rheumatic heart disease?


The government is rolling out its A$40 million plan to evaluate Indigenous health programs. The Evidence and Evaluation Framework aims to strengthen reporting, monitoring and evaluation for programs and services provided to Indigenous Australians.

As Indigenous Affairs Minister Nigel Scullion said last year:

When you don’t know anything about any of the programs, then you’re just relying on gut feelings, and that’s not good enough.

So, the framework will provide information about where government money is being spent, what works and why.

However, from a Western biomedical perspective, the randomised controlled trial is afforded an elevated position in establishing what works and why. While some recommend using RCTs to evaluate Indigenous programs, it is critical to keep in mind why this form of evidence-gathering is not always appropriate in this context.

Randomised controlled trials aren’t real life

In health and medical research, the RCT involves randomly assigning people to different groups and giving the groups different treatments. The random allocation to groups precludes there being systematic differences between participants at the start of the study.

At the end of the study, any differences between the groups can be attributed to the treatment and not some other factor. RCTs, therefore, are an elegant and efficient way of ruling out competing explanations for an observed effect.

However, research participants and scenarios in randomised controlled trials are often unlike the patients and settings to which the evidence will ultimately be applied. For example, RCTs have demonstrated that psychological treatments delivered through the internet can be effective for a wide range of disorders. But in real-world settings, adherence rates to internet treatments are very low, so the RCT result has little practical meaning.

The issue of which particular outcome should take priority can also be difficult to resolve through the RCT approach to research. Most RCTs prioritise the clinical perspective, such as a measurable change in a particular health outcome. However, there can be a mismatch between what doctors view as success and what patients and their loved ones perceive as a positive outcome following drug or other forms of treatment.

For example, it is known anecdotally in Alice Springs that some Aboriginal Australians who could benefit from kidney dialysis treatment prefer, instead, to go back to their community to be on country. While this can be detrimental to their physical health, it has important cultural significance for them.

The RCT approach in this situation would undoubtedly demonstrate the health benefits of kidney dialysis. But understanding this problem in the context of real lives requires different methodologies. Unless we design research programs to consider why people would rather stay on country than receive effective health treatments, Aboriginal health may not improve.

How best to gather evidence

Valuable work can be conducted by health professionals and service providers collecting data during their regular daily activities. The model of the “scientist-practitioner” often observed in clinical psychology could be applied to great effect in remote Australia.

This model promotes a seamless transition between science and practice in which the individual is both researcher and clinician. Scientist-practitioners adopt a critical stance to their clinical practice and routinely demonstrate, through evaluation, the value of the service they are providing.

Such a model was used in a GP practice in rural Scotland. Here, they found one simple change in how appointments were scheduled almost doubled the number of patients (in a six-month period) able to access a psychology service within a reasonable time after referral from their GP.

Rather than clinicians advising patients when to attend the next appointment, systems were organised so patients booked appointments in the same way they would to see a GP. The changes were quantified by clinician-researchers who collected these data in the course of their routine clinical practice.

After this change, patients were able to access the service within two weeks of being referred, rather than waiting for seven months as had been the case. Access to services is typically problematic in rural areas, so discovering a cost-effective means of improving access is an important outcome.

The results were so substantial and sudden that they were unequivocal. A large expensive RCT wasn’t necessary to demonstrate this simple change had made important improvements.


Read more: Aboriginal – Māori: how Indigenous health suffers on both sides of the ditch


This sort of approach could easily be applied in remote Australian settings. An RCT is not the only way, nor even the best way in all situations, to eliminate alternative reasons for the treatment outcomes obtained. Many important questions are ignored or refashioned inappropriately when only one methodology predominates.

Especially in the area of Indigenous health, the health and medical community must be guided by what patients want, not just by what health professionals know how to do.

Aboriginal Primary Health Care Certificate 3 and 4 :@NSWTAFE ” Google School ” delivers to 38 Indigenous #NSW #QLD student graduates

Part of my job is to run clinics in the community, so having my Certificate IV qualification will allow me to check blood sugar, take blood samples and measure body mass index,”

Stephen Taylor from Nowra is studying this Certificate IV course to upskill in his job as an Aboriginal Community Support Worker and Chronic Care Coordinator, which involves monitoring the health of his clients thus minimising hospital visits. He believes these skills will increase his value to his community and to his employer

TAFE NSW Aboriginal Pathways students from across NSW and Queensland benefited from contemporary online learning during their recent studies in primary health care in Port Macquarie.

Originally published HERE

The students are studying the Certificate III or Certificate IV in Aboriginal and/or Torres Strait Islander Primary Health Care and are developing valuable skills like assessing clients’ physical wellbeing, administering medications, providing nutritional guidance, and addressing social determinants of health.

According to Sharon Taylor, Key Account Manager for Aboriginal Pathways TAFE NSW, this is not only the first time Certificate III and IV Practice qualifications in Aboriginal and/or Torres Strait Islander Primary Health Care have been held in Port Macquarie, but also the first time the qualifications have been delivered using the flexible technology of Google Classroom.

“Although they were all first time users, students and staff all spoke enthusiastically of this type of learning, highlighting as outstanding benefits the automatic saving function, online networking and collaborative features,” said Ms Taylor.

Both qualifications have a focus on culturally appropriate application, and workers in this industry are crucial to improving health outcomes for Aboriginal and Torres Strait Islander people.

Amarlee Kelly, one of the 38 students in the two classes, is an Aboriginal woman from Tweed Heads, in Bundjalung country on the north coast of NSW. For Ms Kelly, leaving family and country to study in Port Macquarie took her out of her comfort zone.

“I was very nervous and uncomfortable about leaving my husband,” said Ms Kelly.

“We have been married for 24 years, and we rarely do things without each other. [But] when Uncle Bill performed his amazing Welcome to Country, I was really able to get a feel for Birpai country, and after that I felt much more comfortable and was able to settle down and get to work.”

Ms Taylor added that with Australian Health Practitioner Regulation Agency (AHPRA) accreditation, TAFENSW Aboriginal Pathways are able to offer the Certificate IV in Aboriginal and/or Torres Strait Islander Practice qualification, which enables their graduates to become AHPRA- registered practitioners.

 

Aboriginal Health : Rhetoric to Reality: Devolving decision-making to Aboriginal communities

Delivering services to Aboriginal communities, in a way that involves them as genuine partners and produces effective results, remains an ongoing challenge for public services across Australia.

 ” There are three ways of dealing with people: you can do TO them, FOR them or WITH them. The historic experience for Aboriginal people is the done to, or done for, experience. We need to be doing it WITH them.”

As one of the participants in the research said:

Download the report here : rhetoric-to-reality-report

Delivering services to Aboriginal communities, in a way that involves them as genuine partners and produces effective results, remains an ongoing challenge for public services across Australia.

A new publication, developed by ANZSOG students in conjunction with the NSW Department of Aboriginal Affairs, looks at how the NSW public service can change the way it works with Aboriginal people and better devolve decision making to local communities.

Rhetoric to Reality: Devolving decision-making to Aboriginal communities focuses on what structural and attitudinal changes might be required to deliver better collaborative relationships with Aboriginal communities.

Interactions between Australian public services and Indigenous communities have historically been hampered by a lack of respect, trust and understanding.

The report finds that devolving decision-making to Aboriginal communities should not be seen as an end in itself. It should be a means of practising different ways of working with Aboriginal people that involve sharing knowledge and power, collaborating, and responding to local contexts. If this is done the ultimate result will be better shared outcomes for communities.

Whilst the Australian and international literature highlights many barriers to effective collaboration with Indigenous communities there are very few specific recommendations which go beyond ‘rhetoric’. Rhetoric to Reality provides a range of concrete approaches that NSW Government departments can consider.

 

Shift 1: Connecting to culture, connecting to Country

Key findings

The theme which emerged most clearly from our research was how important it is for public servants to develop and maintain genuine cultural competence. Almost all participants raised some aspect of cultural awareness or competence training as an example of what works and what does not.

Participants felt strongly that the current approach to cultural competence in the public service can be ad hoc, tokenistic, generic and static. Similarly, we found that ideas about cultural awareness, competence, safety or intelligence are not well articulated or understood in the NSW public service. The following statements provided by participants highlight these ideas:

“We’re underdone on comprehensive support for developing cultural competency.”

“I think we can all put our hand up, ‘Yep, job done,’ but then not actually spending any time with Aboriginal communities or adding on that extra layer to think about them.”

“Cultural competency training must be delivered in the most authentic way possible. It has to be real, practical and relevant for staff in their roles.”

“It needs to be honest and delivered by Aboriginal people.”

Research participants considered genuine cultural competence to be critical to changing public sector attitudes and structures. This finding is supported by the literature, which shows that cultural understanding (Zurba et al 2012) and culturally appropriate or safe service delivery (Thomas et al 2015) are important to building relationships with Aboriginal people. Studies have shown that a combination of practices can change structural racism in organisations (Abramovitz & Blitz 2015).

literature also supports the provision of cultural training for staff (Downing & Kowal 2011, Fredericks 2006, Paradies et al 2008). The limitations of cultural awareness training as a stand-alone activity were noted by our research participants and have been noted in previous research (e.g. Downing & Kowal 2011), including the risk of stereotyping, promoting ‘otherness’ and ignoring systemic responses. However, studies have shown it is possible to change prejudiced attitudes towards Aboriginal people through specific education activities (Finlay & Stephan 2000; Pendersen et al 2000 & 2004).

The local decision-making framework recognises that public servants need a level of cultural competence to participate. The Premier’s Memorandum M2015-01 Local Decision Making, states that “NSW agencies will adhere to the principles of local decision-making and ensure staff are educated to respond to the needs of Aboriginal communities in a culturally sensitive and appropriate manner”.

While cultural competence was recognised by our research participants and supported by the literature as a key enabler, the lack of a current framework for the development of genuine cultural competence by public servants persists as a dominant issue in shifting public service structural and attitudinal frameworks.

“The key is having a culturally competent NSW government.”

Below we note a number of recurring ideas for improvement in the understanding and the application of cultural competence in the public service that were raised by research participants.

Accepting that racism and paternalism still exist in the attitudes and structures of the public service and which may be manifested in ‘unconscious bias’ was noted by many participants: “It’s hard to accept we have unconscious bias because people in the public sector are values driven.”

Participants were candid about what they perceive as paternalistic views and subtle forms of racism and bias shown by individuals and institutions: “I believe government and its agencies a lack of faith and trust in Aboriginal people’s ability to make sound decisions in the best interest of their communities.”

Understanding history and the historical trauma experienced by Aboriginal people was viewed as critical. “From a community perspective there is a lot of historical hurt or pain from previous government decisions… You have to let them vent their anger and frustration of the historical decisions that have been made that have had a significant impact on their communities.”

“[A] lot of our staff don’t understand the stolen generation.”

Re-conceptualising cultural competence in the public service as a lifelong journey was seen by many participants as necessary for meaningful change. This includes real experience of working alongside Aboriginal people and communities, and ongoing reflective learning. “We need our staff to keep asking, ‘Why is that the case?’” This finding is supported by the literature, which notes that enhancing a person’s awareness of their biases is critical in reducing modern forms of prejudice and discrimination (e.g. Perry et al 2015).

Building trust was seen as vital. For example, participants talked about public servants, including senior public servants, taking the time before getting down to business to build relationships with Aboriginal people, by having a cuppa on neutral ground, listening and building rapport: “It may take a couple of meetings before you get down to the nitty gritty of developing your relationship with that community.” Building trust and developing genuine relationships were also a strong theme in the literature (Closing the Gap Clearinghouse 2015; Taylor et al 2013; Zurba et al 2012).

Including Country as critical to the development of cultural competence was a universal theme. Participants provided examples of how this could be achieved, including through site-based training, localised activities, travelling

The report’s three key recommendations are that:

  • Cultural competence is most effective when it is localised, ongoing and taught on-Country. Local communities could benefit from being engaged in this teaching.
  • Public-sector leaders who are fully committed to cultural competence are most likely to establish collaboration with Aboriginal communities as a routine approach within government. Examples of successful leadership of this kind should be recognised and publicised across the public sector.
  • Aboriginal public servants should be supported and nurtured, and should be seen as critically important for a culturally competent NSW public service.

Rhetoric to Reality was prepared as part of the capstone Work Based Project subject by ANZSOG Executive Master of Public Administration students Laura Andrew, Jane Cipants, Sandra Heriot, Prue Monument, Grant Pollard and Peter Stibbard. It exemplifies the quality of applied research conducted by ANZSOG’s EMPA students and the potential impact when our students partner with a government agency to help drive change.

The research involved interviews and focus groups with senior executives and frontline public servants in Sydney and regional NSW, to get their perspective on what needed to change to lift the impact of programs on the Aboriginal community.

All recognised the importance of cultural change, and the value of ensuring that successful programs, designed in partnership with local communities, were used as examples to improve results elsewhere.

Rhetoric to Reality will be available across the NSW public service as a valuable resource to ensure that government support for Aboriginal people delivers benefits to those communities.

NACCHO Aboriginal Health and #NSPC17 #SuicidePrevention : Full Transcript June Oscar Conference Speech

 

” Addressing the social disadvantage plaguing our communities is critical to solving many of the challenges facing our peoples, including suicide. It is critical to realizing the human rights of Aboriginal and Torres Strait Islander peoples. Our nation must face up to the devastation that has been wrought upon our peoples and which overwhelms us today.

I have said before, that I will work to make sure that human rights are more than just words on a page for our people, but a part of our lived reality. I know that we have much work to do in order to be closer to that day.”

Aboriginal and Torres Strait Islander Social Justice Commissioner, June Oscar. SEE FULL speech part 2

The worst response to suicide within Aboriginal and Torres Strait Islander communities is to ignore social disadvantage and instead attribute the loss of life to individual failure or weakness.

“Addressing the social disadvantage plaguing our communities is critical to solving many of the challenges facing our peoples, including suicide.

“Our nation must face up to the devastation that has been wrought upon our peoples and which overwhelms us today,” according to the Aboriginal and Torres Strait Islander Social Justice Commissioner, June Oscar.

“The colonisation of our country has come at a great cost for our peoples. We see it everyday in the health and wellbeing of our peoples, in the lack of jobs and in the trauma and disadvantage that surrounds us.

“We see the cost in the eyes of our children who have come to expect this life of pain, of interaction with the care and justice systems, drugs, alcohol and little hope that things will change.

“We must work to challenge the view that somehow our position in society is simply because of our failure or weakness as individuals.

“It is essential that we find ways to ensure that suicide is the rarest of tragedies in our communities. At a time when our peoples are faced by so many challenges, when our life expectancy is already significantly shorter than the non-Indigenous population, we cannot afford to have it shortened even further by suicide.”

Addressing the National Suicide Prevention Conference on 27 July 2017, Commissioner Oscar said the words of colleague Richard Weston are helpful in this context.

“Richard said earlier this year that it’s not about trying to have a debate in this country about blame or guilt for non-Aboriginal people, it’s really just trying to understand how we got to where we are.

“If we understand how we got to where we are, we can create solutions that can change the situation.”

Commissioner Oscar said suicide prevention strategies should acknowledge and build on relationships, culture, resilience and respect.

“These are key to our existence as Aboriginal and Torres Strait Islander people. Our culture is both an ancient and continuing source of resilience. And it is a necessary part of the solutions that we are forging in our communities right across this country.

“Research tells us that strong cultural connections are a necessary ingredient for good health and wellbeing. Of course we already know this but we need to build the evidence base around what works.

“Our culture is the inspiration behind the therapeutic economies giving hope to our women in the Kimberley.

“Similar initiatives exist across the country and we are finding new and innovative ways to broach this difficult subject. I want to acknowledge the work of Walpiri elders for trying to find a way to reach and reconnect with their young people through the development of the Kurdiji App. I look forward to seeing what other creative solutions our people come up with to tackle this important issue. This is the cultural medicine that our people need.

“We also know that bringing about change means moving away from discussions that are based in the ‘deficit’ and channelling our efforts into the strengths-based programs and services such as those that I have already mentioned.

“The language of strength, not deficit is what will keep our cultures and our communities alive.

“We need to shift how Aboriginal and Torres Strait Islander peoples are able to participate in Australian society.

“We need structures, schools, safe spaces where we see ourselves reflected back to us, where we are respected, where we have the same opportunities as others, but also where our voices are heard. I don’t mean having a separate society for our peoples but one where we clearly see a place for ourselves and our children in what exists around us. This is what cultural security looks like.”

Part 2 : Conference Strengthens Indigenous Suicide Prevention : Ken Wyatt

Leading Aboriginal and Torres Strait Islander people involved in tackling suicide have received Australian Government scholarships to enable them to attend this week’s National Suicide Prevention Conference.

Minister for Indigenous Health, Ken Wyatt AM, said their participation would provide important perspectives and contribute to the knowledge shared at the event, to be hosted in Brisbane by Suicide Prevention Australia (SPA) from 26-29 July.

“Sharing ideas, experiences and bringing together people involved in suicide prevention and those with lived experience is crucial to finding the best ways forward,” Minister Wyatt said.

“The Turnbull Government is pleased to sponsor both the conference and the indigenous participants.

“We are committed to suicide prevention around Australia but we need a special focus on indigenous suicide, to help reduce the unnecessary loss of life that contributes to the difference in indigenous and non-indigenous life expectancy.”

Approximately 400 people, including 11 scholarship recipients, are expected at the conference, which has the theme “Relationships, resilience and respect: Responding to vulnerability in life”.

The conference aims to increase the profile of indigenous suicide prevention, with a focus on learning from programs featured in the Aboriginal and Torres Strait Islander Suicide Prevention Evaluation Project.

“The conference will complement the Turnbull Government’s $34 million commitment to 12 national suicide prevention trials, which will gather evidence on better suicide prevention in regional areas of Australia, particularly in high-risk populations” Minister Wyatt said.

Specific areas of focus for the trials include Indigenous communities in the Kimberley and Darwin regions and former Defence Force members in Townsville.

 
Part 3 : Cultural strength is key to suicide prevention : Full Speech

[Introduction in Bunuba]

Yaningi warangira ngindaji yuwa muwayi ingirranggu, Jagara and Turrbal yani u.   Balangarri wadjirragali jarra ningi – gamali ngindaji yau muwayi nyirrami ngarri thangani. Yaningi miya ngindaji Muwayi ingga winyira ngarragi thangani.  Yathawarra, wilalawarra jalangurru ngarri guda.

I stand here today on the lands of the Jagara and Turrbal People. There are many of us that have come from afar, we come speaking different languages, and we are strangers to these lands. The ear of this land is hearing our different languages and we reassure that we gather and talk together with good feeling.

I would like to begin by acknowledging the Traditional Owners of the land upon which we meet, the Jagara and Turrbal peoples.

I am a proud Bunuba woman from Fitzroy Crossing in Western Australia, and it gives me great pleasure to be here with you all to discuss this critical issue that impacts far too many Australians, and far too many of our peoples.

I am all too familiar with the devastation that suicide wreaks on our communities. And it is a sad fact that, like many of you, I speak with firsthand experience of its terrible impacts on my own community.

It is devastating that the Kimberley is going through its second inquest in as many years on this issue. I gave evidence in 2007 and I sincerely hope that this current process can lead to substantive changes that are so desperately needed. But I know that this is an issue that affects so many of our peoples across this nation, not just in my homelands.

I address you today as the first Aboriginal woman appointed to the role of the Aboriginal and Torres Strait Islander Social Justice Commissioner at the Australian Human Rights Commission in 30 years. I look forward to bringing my experiences from living in community to this role and to elevating the voices of our people, throughout my term to address the various challenges facing our communities.

I am proud to follow in the footsteps of my predecessors such as Mick Gooda and Tom Calma who have both been strong advocates on this issue and many others affecting our peoples for many years.

People like Tom Calma and my fellow Western Australian, Professor Pat Dudgeon, have been fighting long and hard to make Governments sit up and take action on this national tragedy – particularly how it effects Australia’s First Peoples.

I will reference their work in the Aboriginal and Torres Strait Islander Suicide Prevention Evaluation Project –in my remarks today.

I am grateful for their leadership and point to their work to tackle the underlying issues of suicide for our people. But I am also grateful for the work of everyone in this room for what you are doing everyday to improve the lives of our people. We have all been touched by suicide in some way or another and together, I know that we have the best chance of bringing hope and change to our communities.

But we know that we know that this is not an issue that we can tackle alone, that the causes are complex and demand responses that address the quality of life of our peoples.

Over the next 30 minutes or so, I want to discuss the historical and societal conditions that lead to suicide and self-harm in Aboriginal and Torres Strait Islander communities. And then, drawing on my own experience in my community in Western Australia, look at the things we know can and must be done to reverse those conditions.

Rights based approach

It is appropriate to highlight the need for a ‘Rights’ based approach in discussing suicide in Australia.

We need to be clear about how a Rights-based framework is critical to understanding how to tackle the causes of suicide.

The Universal Declaration of Human Rights, the bedrock of Rights internationally for the last 70 years says that: Everyone has the right to a standard of living adequate for the health and well-being…(1)

The United Nations Declaration on the Rights of Indigenous Peoples also speaks to the rights of Indigenous peoples, like all other peoples to enjoy the same rights to life, liberty and security. It highlights the particular need for the rights of Indigenous elders, women, children and people with disability to be protected.(2)

These human rights frameworks are a critical starting point for all peoples. But for Aboriginal and Torres Strait Islander peoples, we know that the reality of our existence falls far, far short of these standards. We know that particularly in the remoter parts of the country that our peoples are living on top of each other and sometimes without the benefit of running water. We know the reality of some town camps where, cut off from basic services our people sleep outside, go hungry and struggle to keep warm.

I saw similar conditions during my drive from my home in Fitzroy Crossing to take up my new role the city of Sydney. I travelled through many places across the country and saw our old people living in tin shacks far from essential services. These conditions are a breeding ground for suicide, self-harm and ill health to prosper.

This reality jars against the image of Australia as a prosperous nation. Our country ranks as one of the richest OECD countries on earth and yet Aboriginal and Torres Strait Islander peoples do not sit at this table of wealth.

We know that our nation’s prosperity and our people’s place amongst the most socially and economically disadvantaged are no coincidence. These events are inextricably linked.

The colonization of our country has come at a great cost for our peoples. We see it everyday in the health and wellbeing of our peoples, in the lack of jobs and in the trauma and disadvantage that surrounds us.

We see the cost in the eyes of our children who have come to expect this life of pain, of interaction with the care and justice systems, drugs, alcohol and little hope that things will change.  The normalization of this despair is killing our people.  We must all work harder to change the narrative of low expectations, that is set upon us by others and which we inherit, but we must also demand more from government.

Our very survival in this country, is testament to our strength as a peoples and to our ability to adapt to our conditions. It is evidence of the strength of our culture which we know must be the bedrock of any solutions to many of the challenges that we face.

We know that suicide speaks to our experience as Aboriginal and Torres Strait Islander peoples, as a peoples who are still grappling with our existence in a world that is very different from that of our ancestors.

We must work to challenge the view that somehow our position in society is simply because of our failure or weakness as individuals. We know that much of our experience as First Peoples is a product of the past.

Addressing the social disadvantage plaguing our communities is critical to solving many of the challenges facing our peoples, including suicide. It is critical to realizing the human rights of Aboriginal and Torres Strait Islander peoples. Our nation must face up to the devastation that has been wrought upon our peoples and which overwhelms us today.

I have said before, that I will work to make sure that human rights are more than just words on a page for our people, but a part of our lived reality. I know that we have much work to do in order to be closer to that day.

It would be easy to focus solely on the heartbreak that is suicide in our communities. We must give place to mourning and acknowledgement of those we have lost.

But it is essential that we find ways to ensure that suicide is the rarest of tragedies in our communities. At a time when our peoples are faced by so many challenges, when our life expectancy is already significantly shorter than the non-Indigenous population, we cannot afford to have it shortened even further by suicide.

The power of culture

The power of our culture in healing and the necessity of community designed and led solutions are key antidotes for change.

I am encouraged by the theme of this conference – with the focus on Relationships, Resilience and Respect.

These are key to our existence as Aboriginal and Torres Strait Islander people. Our culture is both an ancient and continuing source of resilience. And it is a necessary part of the solutions that we are forging in our communities right across this country.

We know the healing power and protective role that culture plays in our communities. Our culture kept us safe and healthy long before the British arrived on our shores and long before we even had words to describe the devastation of suicide. It has been a reservoir of strength that has sustained us throughout time.

Research tells us that strong cultural connections is a necessary ingredient for good health and wellbeing. Of course we already know this but we need to build the evidence base around what works.

Our culture is the inspiration behind the therapeutic economies giving hope to our women in the Kimberley – who are creating new lives for themselves away from violence and drug dependence through making wearable art.

Similar initiatives exist across the country and we are finding new and innovative ways to broach this difficult subject. I want to acknowledge the work of Walpiri elders for trying to find a way to reach and reconnect with their young people through the development of the Kurdiji App. I look forward to seeing what other creative solutions our people come up with to tackle this important issue. This is the cultural medicine that our people need.

We know that culture is a critical ingredient of any approach for addressing suicide in our communities and is a lifeline to all of us but especially our most vulnerable.

We also know that bringing about change means moving away from discussions that are based in the ‘deficit’ and channelling our efforts into the strengths-based programs and services such as those that I have already mentioned.

The language of strength, not deficit is what will keep our cultures and our communities alive.

I know that there will be plenty of facts provided at this conference about the size and nature of suicide, so I will just quickly run through a few details regarding suicide in our communities.

In my home state of Western Australia, suicide rates for Aboriginal people in remote areas of the state are some of the worst in the world. It is well documented that self-harm rates are at least 10 times higher than non-Indigenous people.(3)

Across the country, suicide accounts for up to 30 per cent of the premature deaths of our young people under the ages of 18 years.(4)

Aboriginal and Torres Strait Islander young people between the age of 15 and 24 years are over five times more likely to die of suicide than their non-Indigenous peers.(5)

Trauma

It is still not well understood enough in the wider Australian community, why suicide and self-harm are so prolific among Aboriginal and Torres Strait Islander peoples. But for us we know this phenomenon is intimately linked to trauma.

To borrow the term from Professor Colin Tatz, I think non-Indigenous people can sometimes suffer ‘wilful amnesia’ about the history of the First Peoples of this country and this means we are all left poorer for it.

The impact of 200 plus years of colonisation, government policies resulting in dispossession, stolen generations and brutal assimilation have caused a level of trauma that passes from one generation to the next.

Our children and grandchildren continue to suffer the terrible impact of the sufferings of their parents, grandparents and elders.

The words of Richard Weston, are helpful in this context, he said earlier this year that: it’s not about trying to have a debate in this country about blame or guilt for non-Aboriginal people, it’s really just trying to understand how we got to where we are.

So if we understand how we got to where we are, we can create solutions that can change the situation.(6)

A cycle of despair and the toll of intergenerational trauma are the conditions too many Aboriginal and Torres Strait Islander people live with.

We know that a society that boldly acknowledges the wrongs of the past, and is determined to address those wrongs in the present will succeed in creating a stronger and safer place for Aboriginal and Torres Strait Islander people to prosper.

20 years ago, the Bringing them Home report told Australians and the world the truth of the Stolen Generations. It also told us something that we know all too well which is that – “trauma compounds trauma”.

That Report further stated that: Trauma experienced in childhood becomes embedded in the personality and physical development of the child. Its effects, while diverse, may properly be described as ‘chronic’. These children are more likely to ‘choose’ trauma-prone living situations in adulthood and are particularly vulnerable to the ill-effects of later stressors.

The cycle must be broken in order to stem the flow of suicide in our families and communities. We need to ensure that the conditions are right for healing.  We know that the best way to achieve this is by addressing the social disadvantage I spoke of earlier, but also supporting Aboriginal and Torres Strait Islander families to create strong communities as the basis for healing.

The best support structures begin with mentally and spiritually strong families, clans and communities.

Sadly, we know that even the best, most connected, well serviced communities still have a huge challenge in addressing the needs of generational trauma.

The reality is many Aboriginal and Torres Strait Islander communities are dealing with trauma in conditions that are unacceptable for non-Indigenous Australia.

FASD and Suicide

We know that with all the energy in being strong, that some of us succumb to the trauma around us. Far too many of our people and particularly our young people look to drugs and alcohol to numb their pain.

This is an issue that is very close to my heart.

One of the big challenges in our communities, with clear links to suicide and self-harm is the prevalence of Fetal Alcohol Spectrum Disorder or FASD.

There are many symptoms and outcomes of intergenerational trauma but this is one of the most acute issues that I have experienced in community.

After a series of tragic suicides in 2006 a coronial inquest examined why so many Kimberley Aboriginal people were taking their own lives.

Not surprisingly it found that alcohol abuse was the primary reason for the suicide epidemic of Kimberley Aboriginal people.

I have said before, that my own impossible dream was to bring about better life opportunities for the children in my community and town of Fitzroy Crossing. I know that like me, many of us see the pain that our people, carry around and we want to take that away. But sometimes wounds are so deep for cultural medicine alone to fix.

After 50 deaths and attending too many funerals, I found it unacceptable that people I knew were dying in such high numbers from alcohol related preventable deaths. I knew that if we did not act, we would continue to see our families suffering and caught in a rut of grief and loss for years to come.

This was painfully disturbing to see and incredibly difficult to live within this environment of deep sadness, in a country as rich and blessed as Australia in the twenty first century.(7)

In February 2008, the State Coroner described the living conditions for Aboriginal people in Fitzroy Crossing as a “national disaster with no disaster response.”(8)

Remember, trauma compounds trauma.

Along with several other key leaders, we took an unprecedented step. With the support of our elders we lobbied the Director of Liquor Licensing seeking an initial 12 month moratorium on the sale of full strength take-away liquor across the Fitzroy valley.

We were met with fierce resistance, especially from some members of our own community who were addicted to a destructive lifestyle, but we were unrelenting in what we knew was a necessity to break a circuit of chaos and grief.

The restrictions have now been in place for nearly 10 years due to ongoing community support. Many who opposed our efforts are now thankful of the positive impacts that have become entrenched since the restrictions were put in place.

Independent evaluations have shown some great results due to the restrictions; large reductions in alcohol related police interventions, large reductions in alcohol related presentations to hospital and an increase in school attendance.

As a community, we started to change the conditions that incubate suicide and self-harm- but alcohol management is just one plank in the program of solutions that are needed.

Let me be clear, while we have seen some amazing results in my home community in Fitzroy Crossing, alcohol restrictions have never been intended as a panacea.

Alcohol management is just one part of an ongoing strategy for my community. We know that the support services that are desperately needed are often lacking in our communities if they exist at all.

While there has been some good progress in Fitzroy Crossing, we still lose too many people, particularly our young people, to suicide.

I am disheartened to hear that a decade on we are back again before another Coronial Inquiry.

I despair, as I am sure many of you do, knowing that inquiries aren’t a substitute for action but remain hopeful that the findings might translate into meaningful change for our communities.

Hard as it is, I know that we must continue to thrust the suicide epidemic that we are facing across the country into the spotlight.

I thank the work of people like Professors Pat Dudgeon and Tom Calma for doing just this through the work of the Aboriginal and Torres Strait Islander Suicide Prevention Evaluation.

We know from that report, as with all other issues affecting our communities, that approaches to suicide prevention must be community owned and led if they are to be successful.

The Report recognises our holistic approach to health and articulates the connection between culture, healing, social determinants such as housing and education, and the generational impact of trauma.

One of the keys to preventing suicide is to remove the siloed approach to all these issues and instead, consider them all together. Our community controlled services are at the forefront of providing holistic, wrap-around services that look at the entirety of need.

Such approaches are a core part of the ongoing criticisms of how governments tend to organise their programs and services. When it comes to suicide prevention, we cannot afford to live with the chaos of disconnected programs and services.

The Close the Gap Campaign, of which I am a member, has been calling on the Federal government to fund an Implementation Plan for the National Aboriginal and Torres Strait Islander Suicide Prevention Strategy.

This Strategy has a holistic view of our mental, physical, cultural and spiritual health. It has an early intervention focus that works to build strong communities through more community-focused and integrated approaches to suicide prevention.

A considered Implementation Plan with Government support is needed to genuinely engage with our communities, organisations and representative bodies to develop local, culturally appropriate strategies to identify and respond to those most at risk within our communities.

A future Implementation Plan should begin with the recommendations of the Aboriginal and Torres Strait Islander Suicide Prevention Evaluation Project Report from last year.

Conclusion

But there is a final point that I wish to make about this important issue and that is about the issue of place.

Too many Aboriginal and Torres Strait Islander peoples do not feel at home in the place we call our own. We feel at unease at the ever increasing role of governments and other agents in our lives. Daily experiences of racism and disadvantage are the norm and eat away at our health and wellbeing. It is sad that we live in a world so desensitised to our trauma that 10 year olds committing suicide are met with expectation and not surprise.

This is an indictment on our country. This is the story of Australia.

Brick by brick, structures have been built on our ancestral homes, leaving little room for our cultural way of life.

The challenge for us in the modern world is how do we continue to be sustained by the world’s oldest living culture in a society that seems to give it so little value. Walking in two worlds of what it means to be an Indigenous person in this country is not an easy path. Sadly, it is too easy to get swept up in the pain when you are surrounded by little else.

We need to shift how Aboriginal and Torres Strait Islander peoples are able to participate in Australian society.

We need structures, schools, safe spaces where we see ourselves reflected back to us, where we are respected, where we have the same opportunities as others, but also where our voices are heard. I don’t mean having a separate society for our peoples but one where we clearly see a place for ourselves and our children in what exists around us. This is what cultural security looks like.

I want to finish up by using a quote from Yolngu leader, Gularrwuy Yunupingu, which I believe speaks to so many things. He said:

What Aboriginal people ask is that the modern world now makes the sacrifices necessary to give us a real future. To relax its grip on us. To let us breathe, to let us be free of the determined control exerted on us to make us like you. And you should take that a step further and recognise us for who we are, and not who you want us to be. Let us be who we are – Aboriginal people in a modern world – and be proud of us. Acknowledge that we have survived the worst that the past had thrown at us, and we are here with our songs, our ceremonies, our land, our language and our people – our full identity. What a gift this is that we can give you, if you choose to accept us in a meaningful way’(9)

It is my hope that one day we won’t need conferences like these, and that our people will find a place in our country where they feel strong and supported and exist on equal footing with their fellow Australians.

That day is yet to come but being in the presence of you all gives me great hope for the future.

Thank you

Help

Lifeline 13 11 14

Suicide Call Back Service 1300 659 467

BeyondBlue 1300 224 636 or

Mensline 1300 789 978

KidsHelpline 1800 551 800

 

 

 

NACCHO Aboriginal Health and Driving licences: Why they are key to many Aboriginal health, justice and job issues

 ” More than 70 per cent of Aboriginal and Torres Strait Islander people living in remote locations have no public transport, and more than one in 10 Aboriginal and Torres Strait Islander adults report not being able to or having difficulty getting to where they need to be.

Not only would this lack of access be frustrating but it also impacts on health and social inclusion or lack thereof.”

ArticleAddressing the barriers to driver licensing for Aboriginal people in New South Wales and South Australia by Kathleen Clapham, Kate Hunter, Patricia Cullen.

In the Northern Territory, Aboriginal and Torres Strait Islander people make up 84 per cent of the prison population and programs such as these can help reduce incidences of gaol time by preventing people from driving without a licence.

“You get picked up a few times, and very quickly that’s a very serious offence. It’s a really important thing that needs to be addressed.”

While it’s difficult to measure the direct correlation between driver’s licence access and incarceration rates, it’s certainly something that’s likely to have a big impact.”

A key driver behind the program’s success is community participation. “It’s got to be delivered in a way the community wants. The program seems to be very flexible and culturally responsive. The team go out and engage very well with the community, And that does make a big difference that they’ve got the support of the community.”

Lead researcher Professor Rebecca Ivers believes equipping a person with something as simple as a driver’s licence can help address social inequality

Drivers’ licences a road to opportunity for remote Indigenous communities Picture above of Learners                                

 ” One of the stories within this first book talked about the high percentage of clients in the Broome Regional Prison who were there due to a driver-related offence including driving under the influence, driving unlicensed or driving under a ban.”

Article below by  Dr Melissa Stoneham from the Public Health Advocacy Institute of Western Australia

First Published in Croakey SUBCRIBE HERE

In November 2011, the Public Health Advocacy Institute of WA (PHAIWA) released our first West Australian Indigenous Storybook, which was the start of a journey to showcase the many positive stories that occur in Aboriginal communities.

One of the stories within this first book talked about the high percentage of clients in the Broome Regional Prison who were there due to a driver-related offence including driving under the influence, driving unlicensed or driving under a ban.

One of the issues associated with this was that, upon release, many offenders did not have a means of transport. The purpose of the story was to talk about the ‘Life Cycle’ project that targeted pre-release offenders and provided them with skills on how to recondition an abandoned bicycle. The idea included presenting each prisoner, once released, with a bike to ensure they had access to much needed transport.

Now, not all community roads are suitable for bicycles and sometimes the wet season makes it almost impossible to ride a bike, but the general principle is a good one.

Having access to transport, whether this be a private vehicle, a bike or public transport is something many of us take for granted. But for Aboriginal and Torres Strait Islander people in some parts of Australia, accessing public transport and getting and retaining a driver’s licence can be a major challenge.

In this month’s JournalWatch, I am reviewing an article which was published in the Australian and New Zealand Journal of Public Health called “Addressing the barriers to driver licensing for Aboriginal people in New South Wales and South Australia.”

Led by Kathleen Clapham from the Australian Health Services Research Institute at the University of Wollongong, the article used qualitative data collected over a four-month period in 2013 from interviews with Aboriginal and non-Aboriginal stakeholders (n=31) and 11 focus groups with Aboriginal participants (n=46).

The research reported on how barriers to obtaining a driver licence were being addressed in four urban and regional Aboriginal communities: Redfern and Griffith in New South Wales, and Ceduna and Port Lincoln in South Australia.

The stakeholders were classified into a range of agencies including licensing specific agencies, job service agencies, employment agencies, community development agencies, community brokerage agencies, justice systems – police and courts, and state government licensing authorities.

The purpose of these interviews was to ascertain what programs were operating in each site to identify strengths and gaps in programs, funding and responsiveness to community need. All data were coded by themes and allowed for comparison between community member and stakeholder perspectives.

Another reason this research is important is that Aboriginal and Torres Strait Islander people are over-represented in transport-related morbidity and mortality, and have a transport injury mortality rate almost three times higher than the non-Aboriginal population.

More than 70 per cent of Aboriginal and Torres Strait Islander people living in remote locations have no public transport, and more than one in 10 Aboriginal and Torres Strait Islander adults report not being able to or having difficulty getting to where they need to be.

Not only would this lack of access be frustrating but it also impacts on health and social inclusion or lack thereof. Separate to this study, a researcher in the Pilbara region of Western Australia identified how access to culture is impacted by being unable to access transport, including the need to travel for lore business, funerals, hunting and to visit family. Transport is essential for employment, schooling, accessing food, health, cultural and other services and is often a means of escape.

This is particularly so in more remote areas. Let’s take one example. If you lived in the small and remote community of Warakurna, you would need to drive 331 kilometres on unsealed roads to get to Yulara (Uluru) or 781 kilometres to reach Alice Springs.

That is a long way to get to a licensing centre, a hospital or to do a decent shop. In our vast nation, a larger proportion of Indigenous people than others live in the more remote areas of Australia and research indicates that Indigenous people have higher injury rates the more remotely they live.

Barriers to gaining a licence

So what does prevent Aboriginal people from gaining a driving licence and how does not having a driver licence affect the Aboriginal community?

A range of structural issues are involved. These include a lack of sufficient identification such as a birth certificate to prove identity. Lower literacy and the fact that English is often not a first language is a further constricting factor.  The protracted, bureaucratic licensing process, the introduction of graduated licensing and the need to access technology which is not available to all Indigenous people are additional barriers.

The cost of obtaining a licence was also seen as a barrier with one community member stating that “I have a job but because I don’t really get that much so $67 is a lot for me.”

Some of the impacts of under-licensing for Aboriginal people include unsafe transport choices such as overcrowding of vehicles, riding in utility trays and driving unlicensed.

Intersections with the justice system were also raised in the research, with having a state debt due to non-payment of fines frequently cited as a reason for why Aboriginal people were unable to obtain or had lost a licence.

Options to address licensing issues

The authors were able to identify some future options to address the barriers to driver licensing, particularly through the stakeholder data.

All stakeholders were able to cite numerous examples of successful licensing support and driver education courses targeting Aboriginal people, but many of these services had been closed due to lack of funding.

The re-initiation of these types of culturally sensitive courses was seen as a priority action, as was the establishment of government licensing services in remote communities. Some legal stakeholders suggested that providing driver training while people are in custody for disqualification is a potential solution as people in custody have limited access to alcohol and other drugs.

The research found the most frequent suggestions from stakeholders about how to address local Aboriginal licensing issues were:

  • job service networks playing a more active role
  • better use of work and development orders
  • inclusion of driver training in high school education
  • funding licensing programs and community educations courses that included basic literacy skills
  • better provision of services in regional and remote areas
  • legal solutions, such as court diversionary programs.

A quick scan of existing driver licence initiatives for Aboriginal people identified a couple of options including the New South Wales Government offering 1,000 free places on the Safer Drivers Course each year to help young learner drivers from disadvantaged backgrounds and Aboriginal communities. The course helps young drivers on their L-plates prepare for driving solo when they graduate to provisional licences, and teaches them how to reduce road risks and develop safe driving behaviour.

In the Ngarliyarndu Bindirri Aboriginal Corporation (NBAC) located in Roebourne, the Red Dirt Driving Academy employs local mentors to teach local people how to drive safely and retain their licences, with support from Elders. Since 2011 the Academy has been overwhelmed by demand, and has recently welcomed the nearby regional prison authority into the program. The town also has a new road safety mural (featured, right).

Whatever the answer, it is pretty clear we need greater investment in end-to-end licensing support programs for Aboriginal and Torres Strait Islander people, allowing them to more readily gain and retain their driver licence in their local communities and, where possible, with local mentors.

The broad array of structural and community barriers have been identified in articles such as the one reviewed here, and it is now time to use research findings such as these to make it easier and safer for Aboriginal people to get their drivers license.

ArticleAddressing the barriers to driver licensing for Aboriginal people in New South Wales and South Australia by Kathleen Clapham, Kate Hunter, Patricia Cullen., et al. ANZJPH; 41 (3):280-286.

 

 

NACCHO This weeks Aboriginal Health #Jobalerts : #Aboriginal Health Workers #Chronic Disease #TacklingSmoking

This weeks #Jobalerts

Please note  : Before completing a job application check with the ACCHO or stakeholder that job is still available

1.Carnarvon Medical Services Aboriginal Corporation : Chronic Disease Coordinator Close 4 August

2.1-2.4  Western Australia : AHCWA members

3.Tackling Indigenous Smoking Support Officer (OVAHS) close 16 August

4.Generalist HR role Central Australian Aboriginal Congress

5. Registered Nurses Brewarrina Aboriginal Health Service Ltd (BAHSL)

6 -7 Jullums Lismore AMS Registered Nurse / Child and Family Nurse and Aboriginal Health Worker/ Practitioner

8. Rekindling The Spirit  : Positions Vacant – Counsellors

9. Nganampa Health Council  :Personal Care Attendant (Remote Area Aged Care Facility)
 
10.Chronic Kidney Disease Educator – Derby (KRS)
 

11.Kimberley Aboriginal Medical Services Ltd  : Deputy Medical Director (KAMS) – Close 31 July

12.Flinders Island Aboriginal Association Inc.Tobacco Action Worker 

 

How to submit a Indigenous Health #jobalert ? 

NACCHO Affiliate , Member , Government Department or stakeholders

If you have a job vacancy in Indigenous Health 

Email to Colin Cowell NACCHO Media

Tuesday by 4.30 pm for publication each Wednesday

1.Carnarvon Medical Services Aboriginal Corporation   :  Chronic Disease Coordinator (Registered Nurse / Aboriginal Health Practitioner) Close August 4

About the Organisation

Carnarvon Medical Services Aboriginal Corporation (CMSAC) is an Aboriginal Community Controlled Health Service established in 1986. CMSAC aims to provide primary, secondary and specialist health care services to Carnarvon and the surrounding region.

For more information please visit http://www.cmsac.com.au

About the Opportunity CMSAC is currently seeking an experienced Registered Nurse or Aboriginal Health Practitioner to join their multidisciplinary team as a Chronic Disease Coordinator.

As the Chronic Disease Coordinator you will be supported by a diverse team of Doctors, Aboriginal Health Practitioners, Nurses, Medical Receptionists and a Clinical Practice Coordinator providing a range of culturally appropriate and comprehensive primary health care services to the local Aboriginal communities.

Your responsibilities will include (but not be limited to) the following:

  • Providing day to day health services to the community in a professional, confidential and culturally safe manner
  • Utilising a holistic approach to assessing clients and their families by supporting and developing patient understanding of their condition, treatment and prevention strategies
  • Conducting opportunistic screening and follow-up of patients
  • Developing and implementing strategies that promote health education to clients, their families and the community with a focus on chronic disease management and health prevention
  • Providing Support and Advice on appropriate levels of follow-up to clients requiring short and long-term pharmaceutical support including instructing client/care givers how to take medication, the correct dosage, storage and security
  • Maintaining accurate documentation and record of all client encounters on the patient information & recall system
  • Maximising Medicare billings through effective patient records processes

To be successful, you will be a Registered Nurse or Aboriginal Health Practitioner, have experience working in a similar role within an AMS or primary health setting. You will have a sound knowledge of general practice, primary health care and the social and emotional wellbeing needs of Aboriginal and Torres Strait Islander peoples.

Your strong interpersonal, communication and organisational skills will enable you to strengthen existing community partnership, establish and sustain stakeholder relationships, determine priorities and manage workloads in order to meet agreed timelines and achieve results.

Most importantly, you must be able to effectively communicate, promote and uphold CMSAC initiatives and values, acting as a role model in the community.

Before applying please visit http://www.ahcwa.org.au/employment to view the full Position Description.

About the BenefitsA generous remuneration package including salary sacrificing options is on offer.

In addition:

  • CMSAC will negotiate relocation assistance with the right candidate
  • You’ll enjoy a fantastic work/life balance, with Monday – Friday hours, 8:30am – 5pm, with no on-call requirements
  • 5 weeks annual leave

**The successful candidate must be willing to undergo a Drug Screen, provide a current Police Clearance and Working with Children Check and possess a C Class Drivers License.

Aboriginal and Torres Strait Islander people are encouraged to apply.

Applications close 5pm, Friday 4 August 2017

 2. Western Australia : AHCWA members

Current Vacancies

If you are passionate about improving the health and wellbeing of Aboriginal and Torres Strait Islander people across Western Australia then the below opportunities may interest you.

 2.1 Aboriginal Health Worker (50d)

Type: Full Time

Location: SWAMS, Bunbury

Closing Date: 5pm Friday, 4th August 2017

Here at SWAMS we have an exciting position available for someone looking to make a difference. As an Aboriginal Health Worker, you will be involved in clinical assessment and treatment, care coordination, client support and advocacy and community development activities.

2. 2 Administration Assistant

Type: Full Time
Location: PAMS, Newman
Closing Date: Wednesday 2nd August 2017, 5pm

PAMS currently has an opportunity for an Administration Assistant and to join their team on a full-time basis.

2.3 Remote Area Registered Nurse

Type: Full Time 6:2 roster

Location: PAMS, Newman

Closing Date: Wednesday 2nd August 2017, 5pm

PAMS has an opportunity for a Remote Area Registered Nurse to join their team on a 6 weeks on, 2 weeks off, fly in, fly out roster

 2.4 Clinical Operations Manager

Type: Full Time
Location: DYHS, Perth WA
Closing Date: 5.00pm, Monday 31 July 2017

DYHS is now looking for an experienced Clinical Operations Manager to join their team in Perth, on a full-time basis.

4.Generalist HR role Central Australian Aboriginal Congress

In the 40 years since it was established, Central Australian Aboriginal Congress (Congress) has become the largest Aboriginal medical service in the Northern Territory.  Congress is one of the most experienced in Aboriginal health in the country, is a national leader in comprehensive primary health care, and is a strong political advocate for the health of Aboriginal people.

Based in Alice Springs and reporting to the General Manager Human Resources, a newly created role has emerged.  The Organisational Capability Manager is a generalist HR role responsible for developing and leading workforce initiatives, strategic projects, building HR capability and workforce training and development.  Specific areas of focus in the first instance include :-

  • leading a refresh of the people performance and management framework;
  • leading the review of the WHS management system;
  • leading talent planning and implementation activities for organisational change projects and workforce development;
  • strengthening a reporting framework that captures meaningful data to promote organisational performance, assist decision making, minimise risk and enable achievement of the broader organisational objectives and priorities.

Applications are invited from experienced HR practitioners with appropriate tertiary qualifications and superior communication, negotiation and strategic thinking skills.  Experience in developing organisational capability for a large, geographically dispersed and multi-disciplinary entity will be highly regarded.  Pragmatism, intuition, commercial acumen, sound judgement, drive, energy, credibility and authenticity are also important qualities sought.

Offered initially on a contract basis for a period of 2-3 years, there is a genuine opportunity for the scope to extend well beyond this timeframe and expand in breadth of responsibility.  An attractive remuneration package commensurate with skills and experience, together with relocation assistance will be offered in order to attract the right candidate.

For a job and person specification, please visit hender.com.au and for further information on our client, please visit caac.org.au

Applications in Word format only should be addressed to Justin Hinora.

Telephone enquiries are welcome on (08) 8100 8849.

APPLY HERE

5.Registered Nurses Brewarrina Aboriginal Health Service Ltd (BAHSL)

About the Organisation

Brewarrina Aboriginal Health Service Ltd (BAHSL) is a non-profit organisation dedicated to improving not only the health but the youth, culture, education and housing of the organisation’s clients and the Brewarrina community in general. Operating with close ties to the accredited Walgett Aboriginal Medical Service, BAHSL services are available to the surrounding communities and small towns in the area, and provide a resource centre for:

  • Health related issues
  • Medical advice and treatment
  • Individual and family counselling
  • Information and advice about issues relating to substance abuse
  • Sexual health services
  • Family violence
  • Children’s health/issues
  • Adolescent health
  • Women’s and men’s health
  • Healthy lifestyle (including healthy eating)
  • Eye Health

About the Opportunity

Brewarrina Aboriginal Health Service Ltd (BAHSL) has an exciting opportunity for a Registered Nurse to join their multidisciplinary team of dedicated health professionals working throughout in Brewarrina, NSW.

In this role, your primary focus will be on planning, implementing, monitoring and evaluating Enhanced Primary Health Care plans for the program’s clients, in collaboration with BAHSL Aboriginal Health Workers.

To be successful in this position, you will be a Registered Nurse (List A) with experience providing Primary Health Care to those suffering from chronic disease and across a range of other settings. You will require experience in working with Aboriginal communities and have an understanding of health issues in rural/remote areas and the impact of socio-economic factors on Aboriginal communities.

Candidates with previous experience in wounds management, community care, and adult immunisation will be highly regarded.

Please note: Candidates are required to hold registration with AHPRA, a working with children check, and a criminal history check.

BAHSL will reward your commitment with an excellent base salary (dependent upon skills and experience) and access to salary sacrificing arrangements!

Applicants currently located outside the Brewarrina region will be considered – and you’ll enjoy assistance with relocation costs (reimbursed after probation period) and help in finding suitable rental accommodation!

Advance your career in Aboriginal health in this varied role – APPLY NOW!

Please note, due to the nature of this position, Aboriginal people are encouraged to apply.

APPLY HERE

6 -7 Lismore AMS Registered Nurse / Child and Family Nurse and Aboriginal Health Worker/ Practitioner

Jullums Lismore AMS is currently looking for the following positions to join the team:

Registered Nurse / Child and Family Nurse

This is an identified position open to Aboriginal & Torres Strait Islander people

However, Registered Nurses who are not indigenous but able to meet the Selection Criteria are encouraged to apply

Aboriginal Health Worker/ Practitioner

This is an identified position, open to Aboriginal and Torres Strait Islander people

Minimum qualifications, Certificate IV

About Us:

Jullums Lismore Aboriginal Medical Service is a not-for-profit Aboriginal Community Controlled Health service under the management of Rekindling the Spirit, providing primary health care services to Aboriginal people throughout the Lismore area. Jullums is committed to promoting health, wellbeing and disease prevention, involving a holistic approach to diagnosis, and the management of illness.

About the Role:

Reporting to the Practice Manager, both these positions are responsible for a high standard of primary health services that focuses on the prevention, early detection and management of health problems for Aboriginal and Torres Strait Islander people. As a member of a multi-disciplinary team these roles ensure effective screening, service delivery and administration practices are delivered in accordance with our patient centred Model of Care.

The ideal candidates will have proven experience in providing health services to Aboriginal and Torres Strait Islander people.

To request a copy of the Position Description and Selection Criteria, or if you wish to apply for the position by sending a covering letter with your CV, please contact

amanda@rubirockservices.com

8 Rekindling The Spirit  : Positions Vacant – Counsellors

Rekindling The Spirit is a Lismore based, community organisation run by Aboriginal and Torres Strait Islander people for Aboriginal and Torres Strait Islander families, who offer a holistic approach to working with those families and communities to support the achievement of positive and lasting changes in their lives.

Rekindling the Spirit supports Aboriginal and Torres Strait Islander men and women to find their own path of empowerment through spiritual and emotional healing, by offering services that can help relieve poverty, distress, sickness, destitution, trans-generational trauma and other misfortunes. Our counselling, assistance, education and supplementary services focus on reducing the occurrence of domestic and family violence plus child abuse through the promotion of healing and wellbeing within families and the community.

Rekindling The Spirit is looking for a number of Full Time Male and Female Counsellors to provide front line, face to face services to support the implementation and ongoing management of a new program for our clients and community.

Ideal candidates will be Aboriginal and/or Torres Strait Islander people with proven experience in providing counselling services to Aboriginal and Torres Strait Islander people. All counsellors with experience providing counseling services to Aboriginal and Torres Strait Islander people are encouraged to apply to ensure Rekindling The Spirit is able to recruit the highest quality candidates to support our community.

As the successful applicant, you will be responsible for a number of aspects of the programs, including:  Conducting client intake and assessments for the RTS DV Perpetrator Program

  •  Provide face to face counseling
  •  Facilitate Rekindling The Spirit group based activities
  • Conduct exit interviews and evaluation of participants
  • Develop and maintain effective referral pathways
  • Arrange and participate in meetings, team activities, community network presentations, special ceremonies and approved events and field work activities as required
  • Participate in program and service planning, review and evaluation, including data collection and documentation of new initiatives

To be successful, you will:

  • hold a minimum of a Diploma or relevant qualifications in Counselling, Substance Misuse, Mental Health, Aboriginal Health Worker, Community Services or another related field or be willing to undertake further study.
  • have proven experience in providing counselling and/or group facilitation experience in, drug and alcohol, domestic violence, health, social and emotional wellbeing counselling to Aboriginal and Torres Strait Islander people;
  • have a demonstrated ability to work appropriately and effectively with Aboriginal and Torres Strait Islander people;
  •  possess high level communication skills and well developed computer skills.

Aboriginal and Torres Strait Islander people are encouraged to apply.

Criminal history screening and working with children/vulnerable persons checks will be carried out prior to commencement of employment.

If you have a strong interest in this role and wish to apply for the position, please send a covering letter with your CV to amanda@rubirockservices.com

9.Nganampa Health Council  :Personal Care Attendant (Remote Area Aged Care Facility)

Nganampa Health Council is an Aboriginal owned and controlled health organisation operating on the Anangu Pitjantjatjara Yankunytjatjara Lands in the far north west of South Australia. Across this area, we operate seven clinics, an aged care facility and assorted health related programs including aged care, sexual health, environmental health, health worker training, dental, women’s health, male health, children’s health and mental health.

When you join Nganampa Health, you are joining a community of primary health care professionals, united by our desire to make a difference. We learn and experience something new every day, and we are supported by the professionalism and spirit of our colleagues and our organisation.

A fantastic opportunity now exists for a full-time Personal Care Attendant to join our dedicated aged care team, based in Pukatja (Ernabella), in remote North West, South Australia.

Working under the direction of the Residential Care Manager, you will be responsible for planning and delivering person centred care to residentsof theTjilpiku Pampaku Ngura aged care facility.

To be successful, you will have demonstrated experience in Australia as a Personal Care Worker, working with frail, aged and disabled people in an aged care setting. You’ll hold a Certificate III or IV in Aged Care, or an equivalent EN qualification. This could also be a great opportunity for an existing EN looking for a change in role or to move away from a traditional hospital environment.

We are seeking an adaptable and flexible individual who can display the initiative, discretion and cultural sensitivity needed to support and drive the organisation’s objectives and values. You must be able to both communicate and participate effectively within a cross-cultural, multi-disciplinary health team.

Why join the Nganampa Health team

As a Personal Care Attendant at Nganampa Health, you will receive an excellent remuneration up to $58,880 (with Certificate IV qualifications), plus super. You will also receive a range of benefits including:

  • Annual district allowance;
  • Furnished rent-free housing including some meals;
  • Penalty & leave loadings and overtime entitlements;
  • Free electricity and subsidised internet and telephone access;
  • Relocation assistance (negotiable);
  • Generous leave provisions: 6 weeks annual leave, 3 weeks recreation leave, 3 weeks sick leave and 2 weeks study leave!
  • Annual airfares; and
  • Salary sacrificing options to greatly increase your take home pay by up to $16,000!

These incredible rewards bring your salary package up to an approximate $133,000 per annum!

APPLY HERE

10. Chronic Kidney Disease Educator – Derby (KRS)
 
About Kimberley Renal Services
Kimberley Renal Services (KRS) includes 4 Renal Health Centres based in Fitzroy Crossing, Broome, Kununurra, and Derby and a mobile prevention unit.The incidence of Kidney Disease in the Kimberley is one of the highest in Australia. Chronic Kidney disease (CKD) and End-Stage Kidney Disease (ESKD) incidence within the Aboriginal population of the Kimberley greatly exceeds the national burden of disease. Dialysis prevalence for this region has more than tripled in the last decade and is increasing at a much faster rate than in the rest of Western Australia (WA).KRS and the regional Aboriginal Community Controlled Health Services (ACCHS) have developed a renal strategic plan to help combat this health crisis. This has enabled many patients to return to the Kimberley from Perth, which is 2,500kms away, to receive their treatment.

About the Opportunity The Kimberley Renal Service has an opportunity for a Chronic Kidney Disease Educator to join their multidisciplinary team based in Derby WA. This role will be offered on a full-time basis.Reporting to the Renal Health Centre Manager, you will be responsible for raising awareness and understanding of the factors which lead to development of chronic kidney disease.

To be successful in this role, you will be an experienced Registered Nurse – eligible for registration with the national nurses board of Australia – and advanced renal clinical skills. You will also have a commitment to the philosophy and practice of Aboriginal Community Control and knowledge of Equal Opportunity and OSH legislation.

KRS is looking for candidates with strong communication, decision-making and problem-solving skills, along with the ability to work both autonomously and as part of a multidisciplinary team. A high level of integrity and a dedication to maintaining patient confidentiality will ensure you flourish in this position.

About the Benefits

KRS is an organisation that truly values its team, and is committed to improving employee knowledge, skills and experience. In addition, staff development programs are not only encouraged but are often paid for by KRS. These are highly attractive opportunities for someone with a desire to develop their professional knowledge and experience in the area of Aboriginal and Torres Strait Islander health!

There are also a wide range of fantastic additional benefits for the role, including:

  • Attractive base salary of $84,960 PLUS Super;
  • Accommodation Allowance of $13,000;
  • Electricity Allowance of $1,440; and
  • After 12 months of service, you will receive annual airfares of $1,285.

APPLY HERE

11.Kimberley Aboriginal Medical Services Ltd  : Deputy Medical Director (KAMS) – Identified Position

Job No: 90703
Location: Broome, WA
Employment Status: Full-time
Closing Date: 31 Jul 2017
  • Do you want to really make a difference in your career?
  • Take on this rewarding management role with the region’s leading provider of Aboriginal health services!
  • Attractive remuneration circa $230,000 base, PLUS district allowance AND accommodation allowances!

About the Organisation

Kimberley Aboriginal Medical Services LTD (KAMS) is a well-established regional Aboriginal community controlled health service, founded in 1986, which provides centralised advocacy and resource support for 6 independent member services, as well as providing direct clinical services in a further 6 remote Aboriginal communities across the region.

KAMS has successfully delivered high-quality, accessible comprehensive primary health care services over its 30 years of operation and has provided innovation and national leadership in areas such as health information management and evidence-based best practice in primary health care.

About Broome

Broome is located 2,240km north of Perth and has a permanent population of 14,436. Broome promotes a relaxed and easy-going lifestyle, with nearby shopping centres, Sunday markets as well as a broad range of restaurants and entertainment options. It is founded on the traditional lands of the Yaruwu people and is rich in history, culture and beautiful surrounds.

Broome has a deep history in the pearling industry, spanning back to the 1800’s, with memorials throughout the town to commemorate those lost in the early years of pearling. Cable Beach is also a must-see, being named in honour of the Java-to-Australia undersea telegraph cable that reaches shore there. You can explore its beautiful scenery with a bit of 4WDing at low tide, or you can even take a camel ride every day at sunset!

Roebuck Bay is known as one of the most beautiful beaches that surround Broome, with its “Staircase to the moon” phenomenon drawing food and craft markets each time it occurs. The combination of a receding tide and rising moon create a natural phenomenon that can only be described as breath-taking.

About the Opportunity

Kimberley Aboriginal Medical Services Ltd (KAMS) now has a rewarding opportunity for a full-time Deputy Medical Director to join their team in Broome, WA.

Please note: Due to the nature of this role, applicants are required to be of Aboriginal or Torres Strait Islander descent. This is a genuine occupational requirement for this position, which is exempt under Section 14 of the Anti-discrimination Act.

Reporting to the Medical Director, you’ll be responsible for providing comprehensive primary health care in line with accepted best practice standards.

Some of your key duties will include (but will not be limited to):

  • Assisting in the development and maintenance of high quality health services, ensuring continuous monitoring, quality improvement and innovation in the delivery of comprehensive primary health services;
  • Supporting the education, training and on-site up-skilling of the KAMS primary health care workforce;
  • Acting as a cultural champion for health services in the Kimberley;
  • Leading and participating in clinical audit activities in KAMS and member services
  • Assisting the Kimberley Renal Service with medical cover; and
  • Assisting the Medical Director when required.

To be successful you will need:

  • FRACGP, FACRRM or equivalent, with eligibility for medical registration in WA;
  • Significant experience in the delivery of general practice / primary heath care;
  • The ability to act as an effective member of a multidisciplinary health team;
  • Experience in working effectively with Aboriginal people;
  • The competency required to manage emergencies in a remote setting; and
  • A commitment to the philosophy and practice of Aboriginal Community Control.

KAMS are looking for candidates with well-developed interpersonal and communication skills, along with the ability to maintain client confidentially at all times within and outside the workplace. You will have experience working within an Aboriginal Community Controlled Health Organisation or an Aboriginal or Torres Strait Islander Community Organisation and a strong interest in developing the skills required to lead an Aboriginal Health Organisation.

A ‘C’ Class Driver’s License, Federal Police Clearance, Working with Children Clearance, and willingness to travel often by 4WD vehicles and light aircrafts will be required.

To download a full position description, please click here.

About the Benefits

If you are looking for a change of routine, a change of lifestyle or a new adventure, this is the role for you. You will see and experience more of Australia’s real outback than most people ever will – and get paid to do it!

KAMS is an organisation that truly values its team, and is committed to improving employee knowledge, skills and experience. In addition, staff development programs are not only encouraged but are often paid for by KAMS. This is a highly attractive opportunity for someone with a desire to develop their professional knowledge and experience in the area of Aboriginal and Torres Strait Islander health!

While you will face diverse new challenges in this role, you will also enjoy an attractive remuneration circa $230,000 + super. 

There is also a wide range of additional benefits for the role including:

  • On call allowance – 10% of base salary;
  • District allowances – $2,920 single $5,840 double p.a;
  • Electricity allowance $1,440
  • Accommodation allowance $13,000;
  • Mobile phone allowance $100 per month;
  • 6 weeks’ annual leave & 2 weeks’ study leave;
  • Annual Airfares to the value of $1,285 pa (after 12 months of employment).

Don’t miss this exciting and rewarding opportunity to have a positive impact on the health outcomes of Indigenous communities in the spectacular Kimberley region – Apply Now!

Please note: Candidates must respond to the questions below and attach a current resume to be considered.

Apply HERE

12.Flinders Island Aboriginal Association Inc.Tobacco Action Worker 

Flinders Island Aboriginal Association Inc. (FIAAI) currently have a vacancy for a Tobacco Action Worker within FIAAI’s Tackling Indigenous Smoking Program. Contracted until June 2018 (with the possibility of extension beyond this date), this position presents an opportunity to be part of a small Launceston-based team dedicated to reducing the level of Aboriginal smoking throughout Tasmania.

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Reporting to the local Team Leader, this role is available full time or part time by negotiation.

As the Tackling Indigenous Smoking Program involves collaboration with Aboriginal (and other) organisations, schools and Communities around the state, a willingness to undertake some travel in the role is essential.

A driver’s licence is also essential, and significant connection to Tasmanian Aboriginal Communities is highly desirable.

If you’re interested in making a difference to Tasmanian Aboriginal health outcomes and can demonstrate the above we’d love to hear from you.

For more information about this position and a job description which includes process for applying contact Lee Seymour at the FIAAI

Tackling Smoking office on 6334 5721 or via

email at:

lee.seymour@fiaai.org.au