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

“ Too many Aboriginal and Torres Strait Islander people still experience avoidable vision loss and blindness, and those who have lost vision often find it difficult to access the support and services they need.”

Now is the time for all governments and all sides of politics to join together with Aboriginal and Torres Strait Islander communities, their organisations and Vision 2020 Australia members to close the gap for vision.

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

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

Vision 2020 Australia CEO Judith Abbott:

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

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

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

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

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

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

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

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

CLICK HERE for NACCHO Resources 

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

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

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

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

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

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

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

  • Cataract is the leading cause of blindness for Aboriginal and Torres Strait Islander adults and is 12 times more common than for non-Indigenous Australians.
  • Aboriginal and Torres Strait Islander people wait on average 63% longer for cataract surgery than non-Indigenous Australians.
  • Almost two-thirds of vision impairment among Aboriginal and Torres Strait Islander people is due to uncorrected refractive error – often treatable with a pair of glasses.
  • One in 10 Aboriginal and Torres Strait Islander adults is at risk of Diabetic Retinopathy, which can lead to irreversible vision loss.
  • Australia is the only developed country to still have Trachoma, found predominately in Aboriginal and Torres Strait Islander communities.

 

 

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

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

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

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

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

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

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

Alice Springs Declaration

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

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

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

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

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

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

This declaration was unanimously endorsed

Download PDF Copy

CTG19 ALICE SPRINGS DECLARATION

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

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

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

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

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

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

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

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

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

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

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

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

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

It is a story of self-determination.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Read all 50 plus NACCHO Aboriginal Eye Health Articles Here

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

More info Register 

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

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

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

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

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

And now to eyes.

 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Thank you.

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

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

Further, while we acknowledge the scourge of Trachoma, cataract is the leading cause of blindness for Aboriginal and Torres Strait Islander adults and is 12 times more common than for non-Indigenous Australians. We have seen inroads in the rates of trachoma, many thanks to people in this room.

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

Today I want to discuss three things:

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

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

One in 10 Aboriginal and Torres Strait Islander adults is at risk of Diabetic Retinopathy, which we all know can lead to irreversible vision loss. Aboriginal and Torres Strait Islander people wait on average 63% longer for cataract surgery than non-Indigenous Australians. Almost two-thirds of vision impairment among Aboriginal and Torres Strait Islander people is due to uncorrected refractive error- often treatable with a pair of glasses.

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

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

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

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

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

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

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

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

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

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

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

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

Including: Ear infections and otitis media

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

And I think most markedly

  • Rheumatic Heart Disease

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

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

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

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

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

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

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

Under a Shorten Labor government we will be prioritising:

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

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

I think that’s enough from me.

Thank you for your time this morning.

Aboriginal #Eye Health NEWS : NACCHO and @Vision2020 Welcomes @GregHuntMP and @KenWyattMP major investment to provide approx. 18,000 Aboriginal and Torres Strait Islander people with easier access to affordable prescription glasses

“Aboriginal and Torres Strait Islander people have three times the rate of vision impairment and blindness as compared to non-Indigenous Australians.”

“This is totally unacceptable, especially when almost two-thirds of impaired eyesight can be corrected by prescription glasses.”

Health Minister Greg Hunt said the investment would allow Vision 2020 Australia to work with state and territory governments to streamline, standardise and improve their schemes that provide subsidised glasses to First Nations people

Photo above NACCHO File : Brien Holden Vision Institute with Edwina at Danila Dilba ACCHO Darwin

“To help achieve equity of access to subsidised glasses, Vision 2020 will work with governments to ensure their schemes align with eye health principles developed by Optometry Australia and the National Aboriginal Community Controlled Health Organisation.

“These principles have been supported by Aboriginal Health Forums conducted across the nation.”

Indigenous Health Minister Ken Wyatt AM

Under some State and Territory schemes at the moment, only a third of Aboriginal and Torres Strait Islander people needing glasses are actually receiving them.

We need to do what we can to provide cost-certainty and affordable access to prescription spectacles for our people.”

Dr Dawn Casey, Acting Deputy CEO of the National Aboriginal Community Controlled Health Organisation (NACCHO) and Chair of the Vision 2020 Australia policy committee for Aboriginal and Torres Strait Islander Health also welcomed the investment

Read over 40 Aboriginal Eye Health articles published by NACCHO over past 6 years 

Part 1 Program Puts Better Vision for First Nations People in Sight

The Turnbull Government has committed $2 million to provide Aboriginal and Torres Strait Islander people with easier access to affordable prescription glasses.

Welcomes @GregHuntMP and @KenWyattMP major investment to provide approx. 18,000 Aboriginal and Torres Strait Islander people with easier access to affordable prescription glasses.

Indigenous Health Minister Ken Wyatt AM said introducing a nationally consistent system to simplify and ensure better access to affordable glasses would significantly improve people’s vision and overall quality of life.

“Not only does poor vision adversely affect a person’s general wellbeing, it can be a significant barrier to education and employment, and can restrict a person’s mobility and social interaction,” said Minister Wyatt.

“The cost of prescription glasses often deters Aboriginal and Torres Strait Islander people from visiting an optometrist to have their sight checked.”

“This can also delay detection of other serious vision-threatening conditions such as diabetic retinopathy, cataracts and glaucoma.”

A trial to improve the provision of prescription glasses in the Kimberley and Pilbara areas of Western Australia yielded positive outcomes, including improved patient medication compliance and greater independence.

Vision 2020 Australia was established in 2000 and has an experienced board including Aboriginal and Torres Strait Islander representatives.

The Turnbull Government’s 2018-19 Budget included an additional $3 million to extend First Nations eye health activities, on top of an existing $31.3 million commitment to eye health activities

Part 2 New investment in spectacles for Aboriginal and Torres Strait Islander people welcomed by Vision 2020 Australia

Vision 2020 Australia welcomes the Australian Government investment of $2 million to increase access to subsidised spectacles for Aboriginal and Torres Strait Islander people.

The one-off funds have been allocated to Vision 2020 Australia to work with the Australian Government to encourage State and Territory Governments to enhance the existing arrangements for subsidising the cost of spectacles.

Vision 2020 Australia CEO Judith Abbott said: “Our members have been actively advocating for this investment that will help make spectacles more affordable for up to 10,000 Aboriginal and Torres Strait Islander people across our country.”

“Around 60 per cent of blindness among Aboriginal and Torres Strait Islander people is due to issues that can be corrected with glasses, so this is a very positive step. We look forward to working with the government as part of Vision 2020 Australia’s ongoing commitment with our members to reduce blindness and vision loss.”

Minister for Indigenous Health the Hon. Ken Wyatt said: “While subsidised spectacle schemes exist in all Australian states and territories, the existing schemes vary and in some cases, have limited impact in overcoming barriers to access.

This new investment is being provided to encourage State and Territory Governments to work with Vision 2020 Australia to establish a nationally consistent approach to spectacle subsidies.”

“We want to remove affordability barriers so Aboriginal people can get glasses when they need them, regardless of where they live

NACCHO and @Vision2020Aus Aboriginal Eye Health Deadly Good News : #BecauseofHerWeCan #WeCan18 ! – #Indigenous women in eye health @Walgett_AMS @BADACBallarat @AHCSA_ @IEHU_UniMelb

 ” To mark NAIDOC Week 2018 and this year’s theme ‘Because of Her, We Can!’, Vision 2020 Australia is celebrating the roles and achievements of some of the incredible Aboriginal and Torres Strait Islander women working in the eye health sector.  

These women perform a range of roles across a number of areas in the sector, but they are all proud of their cultures, passionate about their work and driven to help improve health outcomes in Indigenous communities and beyond.”

Originally published HERE VISION 2020

Read over 40 Aboriginal Eye Health Articles published over the past 9 years

 ” Vision 2020 Australia’s Aboriginal and Torres Strait Islander Committee Chair, Dr Dawn Casey (COO, NACCHO), said it will be hard to improve Aboriginal health when funding bodies and Aboriginal service providers are “not on the same page”.

Dr Casey spoke at the Close the Gap for Vision by 2020: Striving Together National Conference in March about the longevity of ACCHOs delivering clinically effective health outcomes for over 40 years: “Our mob trust us”. While medical professionals have a role to play in closing the gap, sustainable approaches must be embedded in ACCHOs ”

Read full report here Aboriginal-led solutions key to closing the vision gap

1.Robyn Bradley, Aboriginal Health Liaison Officer – Royal Victorian Eye and Ear Hospital

Robyn’s father’s ancestors emigrated from England and Scotland in the early 1800s and her mother’s family are from the Dhauwurd Wurrung peoples more commonly known as Gunditjmara in Western Victoria.

“I am proud to belong to this beautiful and ancient land. If you listen quietly you can still hear the dreamtime stories of our elders rustling through the bush, whispered over the dessert country and swirling around our brilliant coastlines. I am proud I come from this perfectly crafted tapestry of ancient first nation peoples, emigrants, convicts, pioneers, bushrangers and first fleeters.

“I am also proud to share my passion for my culture and beliefs as an Aboriginal Health Liaison Officer at the Eye and Ear. I get to meet with community and act as a steward to help them receive the highest possible level of care – care that considers what is culturally appropriate and meets their unique needs.”
Robyn Bradley, Aboriginal Health Liaison Officer at the Royal Victorian Eye and Ear Hospital

2. Aboriginal women of the Aboriginal Health Council of South Australia

Since its inception, the Aboriginal Health Council of South Australia (AHCSA) has looked to the leadership of Aboriginal and Torres Strait Islander Women as trailblazers and advocates for better health outcomes for their communities.

Currently there are seven Aboriginal Women working in various roles within the AHCSA Secretariat. The women’s kinship ties extend all over the country and all are united in their efforts to contribute to improving health for their communities, acting as advocates for increased and improved access to Hospital and Health Services and creating opportunities for their communities, particularly the next generation.

Image (L-R): Sarah Betts (Sexual Health Coordinator), Ngara Keeler (Tackling Indigenous Smoking Programme Coordinator), Jessica Koncz (Student Services Officer), Jenaya Hall, (Tackling Indigenous Smoking Project Officer), Amanda Mitchell (Deputy CEO), Debra Stead (Senior Finance Officer),
Absent from photo, Hannah Keain, (Junior Project Officer)
7 Aboriginal women who work at the Aboriginal Health Council of South Australia

3.Keearny Maher, Occupational Therapist – VisAbility

Keearny Maher is a Wiradjuri woman who specialises in vision impairment at VisAbility WA. Her cultural ties originate in Narrandera, NSW through her mother and Wiradjuri woman Ann-Maree Bloomfield.

“One rewarding aspect of my role is helping people find independence again after vision loss, particularly in the simple activities we all take for granted, like making a hot cuppa.”

Keearny’s role takes her all over WA, with some of her career highlights extending overseas, including volunteer work as an occupational therapist in Ukraine and India with children with varying disabilities.

Occupational Therapist at VisAbility, Keearny Maher

Rosamond Gilden, Research Assistant – Indigenous Eye Health at the University of Melbourne and member of Orthoptics Australia

Upon completing a Masters in Orthoptics, Rosamond worked in the private and public sector. To pursue her interest in research, Rosamond joined the Centre for Eye Research Australia as Clinical Coordinator of the National Eye Health Survey. It was during this time she became aware of the poor eye health outcomes for Indigenous Australians and wanted to make a difference.
In 2016, Rosamond commenced work with Indigenous Eye Health and is part of the Roadmap team whose goal is to Close the Gap for Vision by 2020.  Rosamond has used her experiences as a clinician to inform the current work that she is now undertaking and is grateful for the opportunity she has each day to contribute to a sector that has a sincere interest in improving eye health outcomes for Aboriginal people.
Rosamond Gilden

4. Jenny Hunt, Eye Health Worker – Walgett Aboriginal Medical Service in partnership with Brien Holden Vision Institute

Jenny is a proud Gamilaraay woman who has been providing eye care services in partnership with the Brien Holden Vision Institute Aboriginal Vision Program for the past 10 years to the Walgett community.

“I find the eye program rewarding when I see the relief and smile on my people’s faces when they first put their glasses on. I feel proud. Also, if they do not attend their optometrist or ophthalmologist appointments, I will chase them up and take them there myself because I know how important it is for them.
“I have excellent communication with the outreach location workers and they do a wonderful job getting the patients in for our clinics. I travel to Narrabri, Collarenebri, Goodooga, Pilliga and Lightning Ridge for clinics as well as the one we run in Walgett. Without the help from these workers, there would be no eye clinics.”
Jenny Hunt standing in front of a sign for Walgett Aboriginal Medical Service

5.Faye Clarke, Diabetes Educator/Care Co-ordinator – Ballarat and District Aboriginal Co-operative in partnership with Indigenous Eye Health at the University of Melbourne

Faye is a Gunditjmara, Wotjobaluk and Ngarrindjeri woman who works with Aboriginal communities in the Ballarat and wider Grampians region of Victoria to help promote eye health and help those living with diabetes. Faye is passionate about working in Indigenous eye health and was excited to work with the IEH team on the Roadmap to Close the Gap for Vision.

“Vision is such an essential part of our life and when it is threatened it makes all the difference to someone’s quality of life. My dual role as a Care Co-ordinator means I can take on roles in both education and co-ordinating their path in the health care system.

“I am passionate about Indigenous eye health because of the work I do but also because of the clients I work with who are affected by threats to their vision.”

Faye Clarke from Ballarat and District Aboriginal Co-operative

6.Simone Kenmore, Manager of South Australian Trachoma Elimination Program – Country Health South Australia

Simone is a Yankunytjatjara woman from the Anangu Pitjantjatjara Yankunytjatjara Lands in remote South Australia. Simone works with Indigenous communities and health professionals across Australia to inform a model of best practice to work towards the elimination of trachoma in South Australia, and is passionate about improving health outcomes for Indigenous communities.
“I have always been passionate about working in programs that contribute to improved outcomes for Indigenous communities. My work in trachoma is driven by the fact that it is a preventable disease. By sharing what we know about eye health, building the capacity of our communities and working in partnership across health, education and housing we can eliminate trachoma and prevent blindness for future generations.”
(Image and content provided by Indigenous Eye Health at University of Melbourne)
Simone Kenmore

7.Emma Robertson, ITC Care Coordinator – Karadi Aboriginal Corporation

Emma is a Palawa woman working in a health promotion role at Karadi Aboriginal Corporation in Tasmania, encouraging people to come in for regular eye checks. Emma believes this year’s NAIDOC Week is a great chance to honour the women who have influenced her and her work in Indigenous health.

“I thinks this year’s theme is one of the best yet. I get to honour the women who were before my time that set the path that now enables me to work in my areas of passion around Indigenous health. It also makes me feel proud as an Aboriginal mum and the role I am playing in setting what I hope is a great role model for my daughters – that with hard work, determination and good people around you, you can make a profound difference in the lives of others.”

(Image and content provided by Indigenous Eye Health at University of Melbourne)
Emma Robertson from Karadi Aboriginal Corporation

NACCHO Aboriginal Eye Health #NRW2017 : Download @aihw First National Report on Indigenous Eye Health Measures

“The three main causes of vision impairment in adults were uncorrected refractive error, cataract and diabetic retinopathy.

On the positive side, the report indicates that more Indigenous Australians are accessing eye health services provided through specific service programs.

The report finds that in 2014-15 more Indigenous Australians received an eye examination than in the previous twelve months; that the gap in accessing cataract surgery compared to non-Indigenous Australians is narrowing; and the rate of blindness for Indigenous Australians has decreased from 1.9 per cent in 2008 to 0.3 per cent in 2016.

While the report shows improvements are being made in Closing the Gap in Indigenous eye health, more needs to be done.”

Minister for Indigenous Health, Ken Wyatt

Download the  First National Report on Indigenous Eye Health Measures AIHW Indigenous Eye Health

Over 40 NACCHO articles about Indigenous Eye Health

Eye diseases and vision problems are common long-term health conditions experienced by Aboriginal and Torres Strait Islander people and the Minister for Indigenous Health, Ken Wyatt, today welcomed the release of a report that looks at the effectiveness of national eye health programs.

Launching the Indigenous Eye Health Measures 2016 report, released by the Australian Institute of Health and Welfare (AIHW), Minister Wyatt said that one-third of Aboriginal and Torres Strait Islander people reported one or more long-term eye conditions in 2016.

“This report is important because from here we can build an evidence base for monitoring changes in Indigenous eye health, and identify service delivery gaps at the regional level,” Minister Wyatt said.

Summary

Key findings in the report reveal that:

  • This first national report on the Indigenous eye health measures compiles data from a range of sources and presents findings at the national, state and regional levels.
  • In 2016 the prevalence of bilateral vision impairment for Indigenous Australians aged 40 and over was 10.5% and the prevalence of bilateral blindness was 0.3% (both affecting an estimated 18,300 Indigenous Australians aged 40 and over).
  • The 3 leading causes of vision impairment for older Indigenous adults were refractive error (63%), cataract (20%) and diabetic retinopathy (5.5%).
  • Repeated untreated trachoma infections are a cause of vision loss in some remote Indigenous communities, but the prevalence of active trachoma in children aged 5–9 in at-risk communities fell from 14% in 2009 to 4.6% in 2015.
  • The age-standardised proportion of Indigenous Australians who had had an eye examination by an eye-care professional in the preceding 12 months increased from 13% in 2005–06 to 15% in 2014–15.
  • There were 6,404 hospitalisations (4.5 per 1,000) of Indigenous Australians for eye procedures in the two year period 2013—15.
  • Between 2005–07 and 2013–15 the age-standardised Indigenous hospitalisation rate for cataract surgery increased by over 40% from 4,918 to 7,052 per 1,000,000.
  • In 2014–15, the median waiting time for elective cataract surgery was 142 days for Indigenous Australians, with 3.4% of Indigenous Australians who waited for more than 1 year for cataract surgery.
  • Hospitalisation rates for cataract surgery were higher for Indigenous Australians in Remote and Very remote areas combined, while waiting times were longest in Inner regional areas.
  • The number of occasions of service for Indigenous patients under the Visiting Optometrists Scheme (VOS) almost tripled between 2009–10 and 2014–15 rising from 6,975 to 18,890.

Comparison with non-Indigenous Australians

  • Indigenous Australians suffered from vision impairment or blindness at 3 times the rate of non-Indigenous Australians, based on age-standardised rates.
  • In 2014–15, a lower proportion of Indigenous Australians (15%) had had an eye examination by an optometrist or ophthalmologist in the preceding 12 months compared with non-Indigenous Australians (20%), based on age-standardised rates.
  • Indigenous Australians had a lower age-standardised rate of hospitalisations for eye diseases compared with non-Indigenous Australians (10 and 13 per 1,000, respectively), but 3 times the rate for injuries to the eye (1.3 and 0.4 per 1,000, respectively).
  • Indigenous Australians also had a lower age-standardised rate of hospitalisations for cataract surgery than non-Indigenous Australians (7,044 and 8,415 per 1,000,000, respectively).
  • In 2014–15, the median waiting time in days for those who had elective cataract surgery was longer for Indigenous Australians (142) than for non-Indigenous Australians (84).

“We now have a very valuable source of data we can use to improve eye health through better detection, management and treatment of eye disease in Aboriginal and Torres Strait Islander communities,” Minister Wyatt said.

The Indigenous Eye Health Measures report is the first national report on the Indigenous eye health measures.

It brings together comprehensive data from a range of sources and presents this information at the national, state and regional level.

The Australian Government is investing around $72 million over 2013-14 to 2020-21 to improve eye health for Indigenous Australians.

More information about the Indigenous Eye Health Measures 2016 report is available on the AIHW website at http://www.aihw.gov.au/publications/

 

 

NACCHO Aboriginal Eye Health : A game changer for #eye care for #diabetes

eyes

” Diabetes is also a leading cause of vision loss and blindness in Indigenous people and causes 12% of vision loss cases and 9% of blindness cases — rates that are 14 times higher than those in the non-Indigenous population.4

There are many reasons why Indigenous people with diabetes do not receive the appropriate care they need; the Roadmap to close the gap for vision lists 35 individual problems that need to be dealt with to provide this care.7,8

Professor Hugh Taylor

As published MJA : Non-mydriatic photography may be the key to accessible eye care for references

The Roadmap to Close the Gap for Vision has played a part in prompting actions that contribute to this improvement. The Roadmap outlines a whole of system approach to improving Indigenous eye health, and achieving equity between Aboriginal and non-Aboriginal eye health outcomes.

There is however still work to be done on Closing the Gap for Vision. For example, half of Indigenous participants with diabetes had not had the recommended retinal examination.

NACCHO has been involved with the Roadmap from its inception, and had a long relationship with Indigenous Eye Health at the University of Melbourne, and with RANZCO. We’re pleased with the great work and good progress being made.”

 Ms Patricia Turner, Chief Executive Officer, of the National Aboriginal Community Controlled Health Organisation (NACCHO) launching  The 2016 Annual Update on the Implementation of the Roadmap to Close the Gap for Vision November 2016

Download a copy cover

2016-annualupdate

Every patient with diabetes is at risk of losing vision, but up to 98% of the cases of severe vision loss could be prevented.1 At any given time, about a third of patients with diabetes will have diabetic retinopathy, and one in ten will experience sight-threatening retinopathy requiring prompt treatment.2

The National Health and Medical Research Council (NHMRC) guidelines recommend an eye examination every 2 years for non-Indigenous Australians with diabetes, and annual examinations for Indigenous people with diabetes.3

However, approximately only half of non-Indigenous patients with diabetes and only one in five of Indigenous Australians with diabetes receive the recommended eye examinations.4

Although the prevalence rates of diabetes have increased dramatically in Australia over recent years, they have increased even more so among Indigenous people. In the 1970s, the prevalence of diabetes among Indigenous people was one-tenth that of non-Indigenous people,5 and now it is about five times higher.6

For patients with diabetes, maintaining good vision is an essential goal. Not only is good vision important in its own right but, without it, patients cannot manage their diabetes, look after medications, check blood sugars, check their feet and attend clinic appointments unassisted, let alone manage home dialysis.

Diabetes is also a leading cause of vision loss and blindness in Indigenous people and causes 12% of vision loss cases and 9% of blindness cases — rates that are 14 times higher than those in the non-Indigenous population.

4 There are many reasons why Indigenous people with diabetes do not receive the appropriate care they need; the Roadmap to close the gap for vision lists 35 individual problems that need to be dealt with to provide this care.7,8

Consistent with the Roadmap is an important announcement in the May 2016 federal Budget of the new Medicare items for non-mydriatic photography (listed in November 2016), which will enable easy and affordable eye screening within the primary care setting for patients with diabetes.9 This is a very important development and a game changer for both non-Indigenous and Indigenous people with diabetes.

The new item numbers cover a test of visual acuity and a retinal photograph.9 Patients with abnormalities in the eye will need to be referred to a specialist for further assessment and treatment. Patients with a normal eye examination will be reviewed again according to the NHMRC recommendations.

Non-mydriatic cameras are now readily available, and most are at least semi-automatic, making them easier to use by clinic staff. Moreover, non-mydriatic cameras do not require the use of dilating drops, which facilitates patient assessment.

The patient does not need to wait and there is no discomfort of blurry vision for several hours as the drops wear off. Testing visual acuity and taking a retinal photograph in the primary care setting means that a separate specialist appointment is not required, and the eye examination can be easily incorporated into the care plan.

If the vision is found to be impaired or a photograph cannot be obtained, then the patient requires a comprehensive eye examination and should be referred to a specialist, as in the case of visible signs of retinopathy.

This method provides real benefits to patients because the eye examination becomes an integral part of their normal care, avoiding in many cases the need for an additional eye examination and allowing timely treatment, if required. There is a real advantage for the clinic as well, since they can be sure that their patients are receiving the necessary eye examinations.

Moreover, there are also advantages for optometrists and ophthalmologists, because people with diabetes who particularly need their care — those with retinopathy and vision loss — will be referred, rather than them seeing people for widespread screening.

Of course, it is expected that the overall number of people with diabetes being screened will increase significantly, and that changes in the eye will be found much earlier and severe retinopathy will be avoided.

There is also a tangible advantage to the community through cost savings in the identification and care of retinopathy, which will prevent unnecessary blindness and vision loss.10

The impact will be particularly noted among Indigenous people with diabetes, who represent three-quarters of the Indigenous adults who need an eye examination each year.7,

8 In addition to diabetic retinopathy, people with diabetes have an increased risk of cataract and may also need a change in glasses.

To provide adequate eye care to people with diabetes, a referral process for the treatment of retinopathy needs to be established, along with a process of specialist referral for appropriate further investigation and treatment — including post-operative follow-up when required — for those who need cataract surgery or refraction. Those who do not have diabetes will also use these pathways.

The focus on eye care for Indigenous people with diabetes will therefore deal with over 70% of the eye care needs in the community, and it will also assist with providing care for Indigenous patients who do not have diabetes. Again, it is a real game changer.

There are a number of resources to assist with the uptake and promotion of these new services. There are online modules aimed at helping clinic staff learn more about the eye care required for people with diabetes,11,12 for conducting eye examinations and for grading diabetic retinopathy.

In addition, culturally appropriate health promotion material has been specifically developed with close community involvement, which aims to alert and inform patients and the community about the need for regular eye examinations.13

It is said that “what is not measured is not done” and that “what is not monitored cannot be managed”. It is very important that appropriate monitoring and evaluation processes to track performance are put in place at the clinic, regional, jurisdictional and national levels. The diabetic eye screening rate should be a key performance indicator for primary care and diabetes clinics.

The new Medicare item number for non-mydriatic diabetic retinopathy screening is a major advance in closing the gap for vision.

NACCHO Aboriginal Eye Health Survey : Fred Hollows Foundation’s Indigenous Australia Program (IAP)

fred-1

The Fred Hollows Foundation’s Indigenous Australia Program (IAP) is conducting a survey of our partners.

As a valued partner of the IAP , we are keen to understand your views and use these to help us improve.

Completing the survey will take approximately 10 – 15 minutes. The survey is confidential and responses will not be attributed to any individual or organisation.

fred-2

The survey is open from Wednesday the 14th of November  to Wednesday the 30th of November 2016.

GO TO SURVEY

The survey consists of four short sections:

  • Section 1 asks you about your relationship with the IAP
  • Section 2 focuses on the IAP’s guiding principles
  • Section 3 asks you about our partnership approach
  • Section 4 focuses on our organisation, processes and people

Your input will be collated in a way that guarantees the anonymity of your responses. The results will help inform the IAP’s continuous improvement process. Depending on the feedback we receive, we expect to make specific program improvements and/or guide specific advocacy messages. Key survey results and how the IAP plans to address them will be disseminated to partners via email early next year.

Please contact myself jbarton@hollows.org  or Alison Rogers arogers@hollows.org if you have any questions.

Completing this survey can helps us make a positive impact on how the IAP works to increase access to eye health services for Aboriginal and Torres Strait Islander Australians.

GO TO SURVEY

Your participation is greatly appreciated.

Kind Regards,

Jaki Adams-Barton

Manager, Indigenous Australia Program | The Fred Hollows Foundation

fred-1

NACCHO Aboriginal Eye Health : Annual update -The Roadmap to Indigenous eye health is closing the gap

pt-vision

 ” Eye health and good vision is an important issue for everyone, but particularly for Aboriginal and Torres Strait Islander people.

It accounts for a significant proportion of the health gap between Indigenous and non-Indigenous people. I’m pleased to report that progress is being made.

The National Eye Health Survey, released on World Sight Day this year, also tells an important story. Rates of blindness amongst Aboriginal and Torres Strait Islander people have improved from 6 times to 3 times as much compared with non-Indigenous people.

And the prevalence of active trachoma among children in at-risk communities fell from 21% in 2008 to 4.6% in 2015.

The Roadmap to Close the Gap for Vision has played a part in prompting actions that contribute to this improvement. The Roadmap outlines a whole of system approach to improving Indigenous eye health, and achieving equity between Aboriginal and non-Aboriginal eye health outcomes.

There is however still work to be done on Closing the Gap for Vision. For example, half of Indigenous participants with diabetes had not had the recommended retinal examination.

NACCHO has been involved with the Roadmap from its inception, and had a long relationship with Indigenous Eye Health at the University of Melbourne, and with RANZCO. We’re pleased with the great work and good progress being made.”

 Ms Patricia Turner, Chief Executive Officer, of the National Aboriginal Community Controlled Health Organisation (NACCHO) launching  The 2016 Annual Update on the Implementation of the Roadmap to Close the Gap for Vision

Pat Turner pictured above with Mark Daniell President, RANZCO,  and Prof Hugh Taylor at the launch.

vision-crowd

The gap in blindness in Indigenous communities has been halved since 2008 through collective implementation of the sector-supported Roadmap to Close the Gap for Vision, according to a report launched yesterday

Speaking at the Royal Australian and New Zealand College of Ophthalmologists (RANZCO) Annual Scientific Congress in Melbourne, Laureate Professor Hugh R Taylor AC, Harold Mitchell Chair of Indigenous Eye Health at the University of Melbourne said that progress is being made on every single recommendation in the Roadmap to Close the Gap for Vision, which was developed by Indigenous Eye Health at the University of Melbourne.

cover

Download copy of the Report 2016-annualupdate

Eleven of the 42 recommendations have now been fully implemented, with almost two thirds of all activities completed.

“In terms of regional implementation of the Roadmap, there has been positive engagement. We are working with 18 regions across the country covering almost half of the nation’s Indigenous population,” Professor Taylor said.

“We can report that at the beginning of this project, we found rates of blindness and impaired vision were up to six times higher than for non-Indigenous populations. This has now been halved,” he said.

“While the rate stands at three times more than the national average, this is still a very encouraging improvement. With on-going national support, we are determined to reach eye health parity with the rest of the Australian population.”

In his role as Chair of Indigenous Eye Health, Professor Taylor is also working with Indigenous leaders, partners and members of the community in a mission to eliminate trachoma in Australia.

“We are the only developed nation with endemic disease and only in Indigenous communities. Many Indigenous communities are now trachoma free and we can turn our attention to other main causes of blindness and poor vision in Indigenous communities: cataract, refractive error and diabetes,” Professor Taylor said.

Since 2008 rates of trachoma in children in outback communities has fallen from 21% to 4.6%. “We are really seeing some striking progress but we still need to focus on the hot spots.”

“The 2016 Roadmap update shows we are making great progress and are on track to close the gap for Indigenous vision completely in the next four years.”

 

caption

 

 

NACCHO Aboriginal Eye Health : CERA researchers win $750,000 to help end endemic eye disease in remote and regional communities

cera

94% of blindness or vision loss in Indigenous Australians is preventable or treatable and Vision at Home will bring testing to areas with poor access and benefit groups with great potential for sight-saving interventions, including children, the elderly and Indigenous Australians

The largest challenge to preventable eye disease is the lack of access to eye care services in primary healthcare settings, particularly in regional, remote and Indigenous communities. “

Professor Mingguang He, Principal Investigator at CERA

And congratulations to the Australian Literacy and Numeracy Foundation winning $250,000 as a finalist . ALNF aims to revolutionise the teaching and learning of literacy in indigenous communities across Australia.

picture2

Researchers from the Centre for Eye Research Australia (CERA) have won $750,000 after competing in today’s finals of the 2016 Google Impact Challenge held in Sydney.

The prize money will go towards research for the creation of Vision at Home, an evidence-based software algorithm that provides a method for patients to test their eyesight anywhere there is access to a webcam and the Internet.

“I am thrilled our proposal received such a positive response from the competition judges and the general public,” Professor Mingguang He, Principal Investigator at CERA and Professor of Ophthalmic Epidemiology at the University of Melbourne said.

“Our project is a simple hand-held solution for those who live far away from eye specialists and has the potential to help millions of people not only in Australia but worldwide.

“I also want to thank everyone who voted for our project and Google for their extraordinary generosity,” he said. CERA’s Project Lead and PhD candidate, Dr William Yan who presented the project to the Google judges and received the award said he was ‘absolutely stoked’ to win. “It is just sinking in,” he said immediately after hearing the results.

“Now the goal is to create the solution and help those who can’t easily get to treatment,” Dr Yan said.

The Australian Institute of Health and Welfare estimates over 600,000 Australians live with vision impairment, a number projected to increase to 1 million by 2024.

CERA plans to first trial the technology with post-operative patients from the Eye and Ear Hospital, with elderly and disability patients across Victoria, and in schools across indigenous community

How you can share  health messages stories about Aboriginal Community Controlled Health issues ?

Closing this week October 28

  • newspaper-promoEditorial OpportunitiesWe are now looking to all our members, programs and sector stakeholders for advertising, compelling articles, eye-catching images and commentary for inclusion in our next edition.Maximum 600 words (word file only) with image

More info and Advertising rate card

or contact nacchonews@naccho.org.au

Or call Colin Cowell 0401 331 251

NACCHO Aboriginal Eye Health : Why is trachoma blinding Aboriginal children when mainstream Australia eliminated it 100 years ago?

the-eyes

 


 ” Many people don’t know this, but Indigenous Australian children are born with much better eyesight than non-Indigenous children.

Yet, at the population level, Indigenous people at the age of 40 have rates of vision loss three times that of non-Indigenous Australians. Rates of blindness are six times higher among Indigenous adults.

The prevalence of vision problems in Indigenous people is a result of cataracts, diabetic eye disease and a disease non-Indigenous children don’t get – trachoma. In fact, trachoma disappeared from mainstream Australia more than 100 years ago with improved hygiene facilities, water infrastructure and living conditions.

Yet, in some areas, 4% of Indigenous children aged from five to nine years old have an active trachoma infection. In the Northern Territory, that rate is 5%, which is considered an endemic level.

From The Conversation

This article is the first in our three-part series on the blinding, deafening and sometimes deadly conditions in Indigenous Australian children that have little to no impact on their non-Indigenous counterparts. The next two articles will look at rheumatic heart fever and disease; and otitis media.

What is trachoma?

We used to call trachoma sandy blight (the eyes feel gritty, as if full of sand). It is the world’s leading cause of infectious blindness.

Trachoma is caused by the bacterium Chlamydia trachomatis, which creates swelling under the inner eyelid leading to scarring. The scars cause the eyelashes to turn inward and scratch the eye, which is intensely painful and made worse by blinking.

Eventually, if left untreated, all the scratching from the lashes will result in the cornea – the transparent layer at the front of the eye – going cloudy and the person having irreversible blindness.

Trachoma leads to eyelashes turning inwards and scratching the eye, leading to blindness. Community Eye Health/Flickr, CC BY

Trachoma easily spreads from one child to another through infected eye and nose secretions.

Unlike other infectious diseases, a single episode of trachoma is often not uncomfortable or noticed as being any different from just a runny nose. Nor is a single episode such a problem for the individual child.

The main issue is that children keep getting reinfected, which keeps the inflammation present. A child may have between 30 and 40 episodes of reinfection during their childhood and around 160 to 180 infections until the resultant scarring causes blindness.

Each episode of infection may last a few months, but repeated reinfection turns into a continuing infection and disease. The longer the inflammation goes on, the worse the discomfort and more severe the scarring. And the more severe the scarring the greater the risk of blindness.

Where does trachoma exist?

Australia remains the only high-income country to still have trachoma. Although it doesn’t exist in mainstream Australia, trachoma persists in remote Aboriginal communities that still lack safe washing facilities and have notoriously poor and chronically overcrowded housing.

Young children with constant eye and nose secretions in remote endemic communities sometimes go unnoticed and washing a child’s face whenever it’s dirty (with eye and nose secretions) is not common.

But Australia is making progress. In 2009, the Australian government committed to eliminating trachoma by 2020. At that time, disease rates ranged between 15% and 20%. Data from 2015 show a massive drop, with the national average for children in endemic areas at 4.6%.

https://datawrapper.dwcdn.net/GKWxR/1/

Of equal importance is the dramatic reduction in the number of communities with trachoma. More than 150 of the 200 or so at-risk communities no longer have trachoma and there are only a small number with high rates. These hotpots are mainly in and around Central Australia.

Globally, trachoma affects people in remote and rural communities with poor personal and community hygiene. In 2016, an estimated 200 million people are at risk of trachoma in 42 countries – mainly in sub-Saharan Africa, but also in countries such as Afghanistan, India, Brazil, Colombia and some Pacific Island nations.

The World Health Organisation has set the goal of eliminating blinding trachoma by 2020. Countries such as Morocco, Ghana, Iran, Mexico, Nepal, China and Cambodia have eliminated trachoma over the last ten years.


The Conversation, CC BY-ND

What are the treatments?

The World Health Organisation developed the SAFE strategy to eliminate trachoma. This includes: surgery to correct the inward eye lashes (S); antibiotics to reduce levels of infection (A); promotion of facial cleanliness to stop transmission (F); and environmental improvements in water and sanitation (E).

In Australia, the antibiotic azithromycin is given every six to 12 months to all household members of someone with trachoma, or everybody in affected communities.

This brings down the level of infection, but without stopping the possibility of transmission, trachoma will bounce back. This is why keeping every child’s face clean is so important. The essential and sustainable strategy of maintaining trachoma elimination comes down to having clean faces, which goes with access to safe and functional bathrooms and washing facilities.

Milpa the Trachoma Goanna mascot features in the materials and is involved in community activities. Author provided

Improved hygiene will also help reduce other common and very serious infections in remote Indigenous communities.

There are currently effective health promotion activities in Australia such as “Clean Faces, Strong Eyes”. Bodies such as the Indigenous Eye Health group at the University of Melbourne continue to work closely with community groups to build on this work.

Milpa the Trachoma Goanna mascot features in educational materials and is involved in community activities, such as the development of music videos, roadshows and football clinics.