NACCHO Aboriginal #Eye Health #refreshtheCTGRefresh : @AHCSA_ @RANZCOeyedoctor @IEHU_UniMelb has launched the 2018 Annual Update on the Implementation of The Roadmap to #ClosetheGap for Vision

“All of these improvements are very encouraging, but more needs to be done if we want to achieve our goal of giving all Aboriginal and Torres Strait Island people the same eye health as other Australians,

“It is crucial that we keep working closely with local communities through Aboriginal Community Controlled Health Organisations, and at higher levels to make sure that services are properly provided and resourced across states and territories.”

Professor Hugh Taylor, Head of Indigenous Eye Health at Melbourne University

” The feeling of restoring someone’s sight is what Taylor describes as “almost biblical”.

The surgery for restoring sight is often quite simple, but the impact of the surgery, and the emotional response that comes with it, often leaves Taylor at a loss for words.   

While 94 per cent of vision loss is avoidable, Aboriginal and Torres Strait Islander adults are six times more likely to suffer from blindness than non Aboriginal and Torres Strait Islander adults.

After working in remote Indigenous communities with the Fred Hollows Foundation, as well as overseas, and seeing little change in the statistics over a number of years, Taylor decided it was time to take serious action on closing the vision gap.

Taylor is on a mission to close the gap by 2020, through sustainable health systems that will change the landscape of Indigenous eye health, forever.  

In this months Changemaker, Prof Taylor discusses why he was inspired take charge of Indigenous eye health, creating sustainable solutions, and the feeling of restoring a human’s eyesight. See Full Interview Part 2 Below

Download 2018-AnnualUpdate_Close the Gap

Part 1:The Roadmap to Close the Gap for Vision

The 2018 Annual Update on the Implementation of The Roadmap to Close the Gap for Vision was launched on this week at the 50th Annual Scientific Congress of the Royal Australian and New Zealand College of Ophthalmologists in Adelaide by Shane Mohor, CEO of the Aboriginal Health Council of South Australia and Professor Hugh Taylor, Head of Indigenous Eye Health at Melbourne University. Dr Heather Mack, President-Elect of RANZCO hosted the launch.

Philip Roberts from the indigenous eye health unit hard at work

“It is terrific to see the progress that has been made with great work being done by the Aboriginal and Torres Strait Islander health organisations and all of our partners in eye health,” Professor Taylor said. Progress includes:

  • 19 of 42 systemic issues identified in Indigenous eyecare have been fixed and three quarters of the intermediate activities have been completed
  • In 2008 blindness and impaired vision among Indigenous people were six times the national rate. Now it is down to three times the national rate
  • A third of Indigenous adults have diabetes and are at risk of blindness through diabetic retinopathy
  • Up to 98 per cent of diabetes-related blindness can be prevented through annual eye exams and timely treatment in the disease’s early stages
  • Diabetic retinopathy cameras and trained operators are being placed in more than 150 Aboriginal health clinics across Australia
  • 53 of 63 regions across the country are now working to co-ordinate eye care for Indigenous people – covering more than 70 percent of the nation’s Indigenous population
  • The rate of trachoma, a blinding eye infection passed child to child and prevented by keeping faces clean, 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
  • Australia remains the only developed country with endemic trachoma, which is only found in Indigenous communities. Prompt repair and maintenance of washing facilities is key to helping children wash faces, while more timely data-reporting would allow targeted intervention in trachoma hot spots.

Part 2 : In this months Changemaker, Taylor discusses why he was inspired take charge of Indigenous eye health, creating sustainable solutions, and the feeling of restoring a human’s eyesight.

Republished from Maggie Coggan Article Probono

What made you want to specialise in Indigenous eye health?

Back in the 70s, when I was doing my ophthalmology training, I spent a year working with the Fred Hollows Foundation. Over a period of a year or so, we examined Aboriginal and Torres Strait Islander people across the whole country, and this gave me a real insight into some of the conditions and disadvantages of Indigenous people across the country.

It was when I did a review for the Commonwealth, in the mid 90s on Indigenous eye health, and made a series of recommendations, that I realised in 30 years, nothing had changed. I realised no one else seemed to be doing much to make a change, so I rolled up my sleeves and got on with it, moved to Melbourne University and set up the eye health unit, to really try and focus on this problem full time.

When you were working in those remote communities, at what point did you realise it was a really big problem?

I’d been brought up in middle class family, and went to school and university in Melbourne, living quite a privileged life.

Keep in mind, I was there over 40 years ago, so things have changed, but when I was working in these remote communities, many were wearing old second hand clothes, lacking facilities to wash themselves or their clothes, with eye, nose, ear and skin infections. It was very different from walking around suburban Melbourne or working in the emergency room or outpatient clinic. \

That fellow Australians were allowed to live like that was just not right and a real shock. I just couldn’t understand how that could happen in Australia. It was when I went overseas and did work in Africa, Asia, America and the Middle East, and saw what can happen and change there, that I realised things hadn’t changed in Australia and we needed to do something about it.

Dr Hugh Taylor screening for trachoma

Why did you think setting up your own clinic and area of work was more effective than the work you were doing with Fred Hollows?

The stuff I did with Hollows was really a survey, and one-off eye care, and an attempt to set up ongoing eye care. I was then one of the founding board members of the foundation, they weren’t really doing much in the Indigenous eye health space, mainly focusing their work overseas. I was also running a big clinical department and research group, and the Centre for Eye Research Australia, amongst other things, and it only left an hour or two a week to think about Indigenous eye health.

I really wanted to develop long term and sustainable changes, rather than having one-off services, that needed time and effort to identify the problems, and then working out what the solutions are, and how they could be best rolled out.

Restoring someone’s eyesight is a pretty significant act, what does that feel like for you doing the work?  

Ophthalmology is almost biblical. You’re making blind people see again, and that can be both rewarding for the patient and the family, but also for the practitioners. Sometimes it’s quite embarrassing, because all you’ve done to people, once you’re trained, is a simple operation. But taking out someone’s cataract, particularly if it’s a very advanced cataract, to take that out and do it properly, you feel very satisfied at the end of surgery.

The next day when you take off the bandage and the dressing, and the patient is bursting with emotion, and joy at being able to see, count how many toes they have or touching their nose. Sometimes they are so excited, you really don’t know what to say, and that’s really very moving and very exciting.

Are there other reasons aside from a lack of services that contribute to the high numbers of vision loss for Indigenous people?  

Well it’s interesting, because when we first set up the Indigenous eye health unit, we did a survey and found that the unmet need in the inner-city Melbourne suburb of Fitzroy, is the same as it is, in Fitzroy Crossing, up in the Kimberley.

In the Kimberley, we obviously need to get more eye services out there, but the Victorian Aboriginal health service in Fitzroy is less than a mile from the Royal Victorian Eye and Ear Hospital, the largest eye hospital in the Southern Hemisphere.

They were also having seven times less surgery to remove cataracts, and they were four times more likely to wait for more than a year to get surgery done. Some of the reasons for not using services were for simple things like cultural safety, or institutional racism that was keeping people away.

Other things were the movement of more and more surgery into private hospitals, with big gap fees. We ended up saying that the path of care was like a leaky pipe, there are lots of cracks where people can fall out of the system, and if you only fix one or two cracks, the pipe is still leaking. You actually have to address each of those issues, to fix the pipe.

Changing behaviour through education

Do you feel you’ve received enough support from government?

We’ve had a lot of support from government, and there has been a lot of things done. Of our road map, there were 42 recommendations, and more than 16 of those have been fully implemented, and we have a first step done on every one of those, and about two-thirds or more of the intermediate steps have been done.

So we are actually making really good progress.

The government has put in a whole lot of funding into quite a number of those recommendations, and made a number of those changes. There’s still more work to do, and we’ve made good progress, rolling out this improved way of delivering eye care, we have halved the gap for blindness, but more needs to be done to implement those recommendations across the country. We are hopeful this will happen in the next funding cycle, people see what progress is being made, and we live in hope that we will close the gap for vision in 2020.

Do you think vision loss receives less attention because it doesn’t immediately cause death?

Something we outlined in our report on closing the gap, is the false reasons for not doing something about blindness. People say it doesn’t kill you, but actually, if you have visual impairment you have more than a two fold increased risk of dying. Vision loss caused 11 per cent of the health gap.

The first is heart disease, the second is diabetes, equal third is trauma and vision loss. It’s actually very important. The second is people say you can’t do anything about it, and it’s just a natural part of ageing, but in fact, 94 per cent of the vision impairment is unnecessary, and it’s treatable.

Much of it can be fixed overnight. You can give someone a pair of glasses, they see right away, and if you do cataract surgery, they will see the next day. So unlike some of these other chronic problems, like alcoholism, or heart disease, or kidney failure, with vision loss, most of it we can actually fix.

What we see, is the eye care is providing a paradigm or a template on how to link primary care with the specialist services, because if we can sort it out for eyes, it can work for hearts, and lungs and kidneys.

Why exactly is it that blindness is linked to shorter life expectancy?

People who have vision impairment, have a doubling risk of falls, an eight fold increase of hip fractures, are three times more likely to have depression, and you can’t actually get around to look after yourself, or go to the doctor or participate in community and religious events.

And in addition, if you’re so blind from diabetes, you can’t check your blood sugar, you can’t check all your pills, or your feet to make sure they aren’t having problems. There are some very serious impediments that happen because of sight loss. It also prevents healthy and independent ageing.

I mean, Makinti Napanangka, who won the 2008 Telstra Art award, had to stop painting because she was blind from cataract, and after she had surgery, she took out the award, and that’s fantastic. From not being able to take yourself to the doctor, or make a cup of tea, she was able to return to her career after surgery, so it’s really important.

What are you currently working on?

Our focus at the moment is working with advocacy and government to try and get additional funding, particularly the increase in funding for the visiting outreach services for ophthalmology and optometry, and funding for case management of patients who need care referrals in their treatment. We are doing a lot of work making sure that everyone with diabetes gets the regular treatment and that’s also across the country.

In the area of trachoma, while we’ve had very good progress, there is still much more work to be done to eliminate it as a blinding disease. For that we are focusing on health promotion so that every child and family knows to keep the kids faces clean, to stop the transmission of infection, and also to make sure there’s washing facilities in the houses and schools, so the kids can actually make sure that they can wash their faces.

Do you think it’s possible to close the vision gap by 2020?

Yes! There’s a lot of work to do, but you’ve gotta back things that work, and we are actually making real progress. We’ve already halved the gap for blindness, reduced the rates of trachoma in kids from remote communities from 21 per cent in 2008 to 3.8 per cent, so I think we are making some really good progress, we just need to have the support to finish the job.

What are you doing to ensure that the organisation that is set up is sustainable and continue on?

My little group may disappear, and that’ll be fine, what we are really trying to do is develop long term sustainable changes so that this system just keeps on running.

Once it’s set up in place, they’ll be checks and balances with monitoring and reporting, and the evaluation of reporting. So it’s really about building those sustainable solutions, building things into medicare, changing government policy, so services are properly funded and coordinated.

I started 40 years ago, dropping into communities and fixing eyesight and then leaving, and that’s not what we should be doing in 2018, we need to be more sustainable.

The national Close the Gap campaign extends beyond just eye health, does the complexity of the issue overwhelm you?

It is complex, and I recognise that but no I don’t feel overwhelmed. I actually feel empowered by recognising it’s complexity. Stepping back and taking this health system approach, looking at the patient journey or the pathway of care, coming up with the notion of it being a leaky pipe with many issues to fix is important.

There’s no silver bullet, it’s not the three key priorities. I’m quite empowered by a quote from Helen Keller, who said I am only one, and I can’t do everything, but I am one, and I can do something, and because I can’t do everything, doesn’t mean that I won’t do the something that I can do.

With eye care, you can actually do it, and teasing out the real things that need to be done and as I said, most of it can be fixed, and most of it can be fixed overnight. I think we are making really good progress, and learning the lessons that we’ve been working out for eye care to apply for the provisions of other specialist health services.

How has this experience changed you?

I guess it makes me optimistic that we can change, and recognising that there’s not a silver bullet, there’s not just three things that need to be done, you need to take a health systems approach, and look at the multiple things.

And so taking a complex problem and unpacking it has been very important, and I think that has given me the optimism for when people ask if we can get it all done by 2020, because of course we can! If we can keep pushing on and kicking a few goals, it’s very doable, we will get there.

 

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

Aboriginal Eye Health #NDW2017 : Fact check: Has trachoma among Indigenous kids fallen from 20pc to 4pc ?

” On the final day of the Uluru convention on a referendum for Indigenous constitutional recognition, former prime minister Kevin Rudd spoke to the ABC about Indigenous disadvantage since his National Apology to the Stolen Generations in 2008.

Mr Rudd told Radio National on May 26: “One of the programs that we established back then was to eliminate trachoma amongst Indigenous young people. Twenty thousand kids were suffering from trachoma back then at about a 20, 25 per cent rate. We’re now down to about four per cent.”

Is Mr Rudd correct about the incidence and decline of trachoma among Indigenous young people? RMIT ABC Fact Check investigates

Originally Published HERE

NACCHO Declaration

Read over 40 NACCHO Eye Health articles we have published over 5 years

 ” 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

 

The verdict

Mr Rudd’s claim is overstated.

In saying that 20,000 kids were suffering from trachoma, Mr Rudd appears to have used data for the number of children living in communities judged to be at risk of having endemic trachoma. The number of children estimated to have trachoma in 2009 was about 3,000.

His rate of 20 to 25 per cent “back then” is supported by a prevalence figure of 21 per cent contained in a 2008 report. However, the rates for 2007 and 2009 were each 14 per cent, and the report for 2009 cautions about the reliability of the 2008 data.

Rates of trachoma among Indigenous children in at-risk communities have declined steadily since 2009. The claim that rates have fallen to about four per cent is supported by recent reliable data.

What is trachoma?

Trachoma is a contagious infection of the eye that, with repeated long-term infections, can result in the eyelashes turning inwards and scratching the cornea, leading to blindness.

Trachoma affects children and preschool-aged children in particular. It is commonly spread through nose and eye secretions, occurs in areas with poor community and personal hygiene, and is associated with overcrowding and reduced access to water.

Australia is the only developed country where trachoma is still endemic, and it occurs primarily in remote Aboriginal communities in Central Australia.

What program did the Rudd government establish?

Professor Hugh Taylor is the Harold Mitchell Professor of Indigenous Eye Health at Melbourne University and when Mr Rudd announced the policy in 2009 he was head of the National Trachoma Surveillance and Reporting Unit, which receives funding from the Federal Department of Health.

Professor Taylor told Fact Check that “after years of either inaction or ineffective action, in 2009 Kevin Rudd committed to eliminate trachoma in Australia by the year 2020”.

Australia adopted a trachoma eradication strategy in line with the World Health Organisation’s 1998 global strategy and based on its SAFE guidelines. SAFE stands for [S]urgery to repair inward eye lashes, [A]ntibiotics, promotion of [F]acial cleanliness, and [E]nvironmental improvements in hygiene and water access.

Mr Rudd’s office told Fact Check the policy he was referring to was a $58 million commitment made in February 2009 to “help tackle eye and ear diseases in Indigenous communities”, with a major focus on trachoma eradication.

The funding was to be allocated over four years, and according to a press release at the time, included “a major increase in services to address trachoma, which will enable at least 10 regional teams to treat and help prevent the disease in NT, WA, SA and other states where trachoma is identified”.

The 2009-10 federal budget papers spell out $58.4 million in funding over four years for “improving eye and ear health services for Indigenous Australians”.

According to the National Trachoma Surveillance and Reporting Unit, in 2009 the Government committed $16 million over four years towards eliminating trachoma in Australia, and in 2013 committed a further $16.5 million.

The source of the claim

When contacted by Fact Check, Mr Rudd’s spokeswoman said reports for 2008 and 2015 by the National Trachoma Surveillance and Reporting Unit were the source of his claim.

Fact Check was unable to find another consistent, national source of data on the prevalence of trachoma in Indigenous communities. Experts confirmed that there was not any other reliable source.

In the unit’s data collection process, communities are classified as being at risk or not at risk of trachoma and screening of the disease focuses on the at-risk communities.

Screening is administered by local health officials who report the data back to the surveillance and reporting unit for collation and analysis.

Coverage of trachoma screening of at-risk communities has increased over time, due to the increasing level of resourcing of the trachoma eradication program.

20,000 kids with trachoma?

Mr Rudd’s February 2009 media release contains the sentence: “Approximately 20,000 Indigenous children suffer from trachoma in Australia.”

Mr Rudd’s office told Fact Check that “in 2009, it would appear the material provided by the Health Department to the Government referred to 20,000 kids suffering from trachoma”.

His spokeswoman pointed to a May 2009 media release from the then Indigenous affairs minister Jenny Macklin which contained the same sentence and a July 2009 speech by the then parliamentary secretary for social inclusion Ursula Stephens who said: “Trachoma affects approximately 20,000 Indigenous children — a stunning statistic and one that is confronting to government.”

However, a spokeswoman for the Department of Health told Fact Check that “the number of children screened and found to have active trachoma was 997 in 2008 and 575 in 2009”, and “we can confirm that the figure of 20,000 children relates to the number of children resident in potentially at-risk communities (population data), not those screened and found to have trachoma”.

The National Trachoma Surveillance and Reporting Unit’s report for 2009 says there were “20,155 children aged one to nine years resident in the 232 at-risk communities”.

Of these children, 4,116, or 20 per cent, were screened and 575 children had trachoma.

“If those 4,116 children screened were a representative sample of all 20,155 children resident in all at-risk communities, the additional number of children estimated to have trachoma across the three jurisdictions lies between 2,045 and 2,448,” the report said.

It appears that all three ministers were referring to statistics available at the time about the number of children at risk of contracting trachoma, not the number who were suffering from trachoma.

Professor Taylor told Fact Check that “the estimate in 2008 was that there were 20,000 kids in remote communities considered to be at risk of trachoma”.

“This is a rubbery figure because not all the communities had been examined,” he added.

The prevalence of trachoma in 2008

The executive summary of the National Trachoma Surveillance and Reporting Unit’s 2008 report says that “the prevalence of active trachoma in those communities from which data were reported was 21 per cent”.

Of 287 remote Aboriginal communities, 235 were identified as at risk of trachoma in 2008, and 121 were screened and reported data.

The 2008 report focused on the prevalence of trachoma in Indigenous children aged one to nine years old.

Fact Check notes that both the 2007 and 2009 reports show the trachoma prevalence in Aboriginal children aged one to nine years old in communities that reported data in those years to be 14 per cent.

The discussion section of the 2009 report says that “in 2008, there was an abrupt two-fold increase in trachoma prevalence in NT, and an equally abrupt seven-fold decrease in trachoma prevalence in SA, compared with past years. Both of these sudden changes were reversed in 2009”.

The report says the variation in the numbers “suggests that the data from 2008 might be problematic”.

Professor Taylor told Fact Check that “there is an inconsistency in the data and it’s appropriate to acknowledge it, but those are the data that we have, and those are the data that we must use”.

Carleigh Cowling, senior surveillance officer with the National Trachoma Surveillance and Reporting Unit, said the Northern Territory intervention had an impact on the collection of the data in 2008.

“During the intervention, the trachoma screening program was taken over by unusual bodies, whose training was questionable,” she said, adding that “data collected by those teams were not presented in the 2008 report, which does make the data presented problematic”.

The prevalence of trachoma today

The most recent report from the National Trachoma Surveillance and Reporting Unit, published in June 2016 and containing data for 2015, shows that 139 communities were identified as being at risk of trachoma, a decrease of 96 communities since 2008.

Of these 139 communities, 67 were screened and reported data.

The 2015 report focused on children aged five to nine, though reports prior to 2010 focused on children aged one to nine. “It’s an assumption that one to four-year-olds are similar,” Professor John Kaldor, the current head of the National Trachoma Surveillance and Reporting unit, now part of the Kirby Institute at the University of New South Wales, said.

Professor Taylor and Ms Cowling both told Fact Check that though the 2008 report focuses on children aged one to nine and the 2015 report on children aged five to nine, this will have little impact on the comparability of the data from those years.

The results, for children aged five to nine as against one to nine reported in 2008, reveal that the prevalence of trachoma in the communities that screened was 3.7 per cent. The prevalence “using the most recent data carried forward in all at-risk communities” was 4.6 per cent.

The 3.7 per cent is for at-risk communities that screened in 2015, and the 4.6 per cent is for all at-risk communities, meaning those that screened and those that didn’t screen that year but are considered at risk based on previous data.

Professor Kaldor said policy guidelines changed in 2014 so that if a community had high rates of trachoma several years in a row, resources were shifted towards treatment rather than screening.

He and Professor Taylor both agreed that the current prevalence of trachoma among children in affected communities was about 4 per cent.

Professor Kaldor said of hotspots that still exist in Central Australia: “While the drug azithromycin is a big part of combating the disease, there’s the whole issue of fulfilling the other parts of the SAFE strategy to sustainably improve facilities and living conditions.”

“If these are not addressed, the impact of treatment may be short-lived.”

Professor Taylor told Fact Check that “since 2008 we’ve made considerable progress”.

“If you look at closing the gap, it’s actually one area where you can say we’ve made considerable progress,” he said.

Sources

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 Eye Health News : Fred Hollows Foundation partners with Aboriginal community Controlled Health sector for workforce initiative

TFHF Cadetship_L-R Brian Doolan (TFHF) John Brumby (TFHF) Lauren Hutchinson (student) Gabi Hollows (TFHF) Adrian Carson (IUIH)

We know that 94 per cent of vision loss among Aboriginal and Torres Strait Islander people is preventable or treatable, yet more than one-third of adults have never had an eye exam,

“We think having Aboriginal and Torres Strait Islander people as health professionals will reduce this figure – there really is a point of difference when it’s an Aboriginal or Torres Strait Islander person looking at your eyes, or taking care of your health,”

Jaki Adams-Barton, Manager of the Indigenous Australia Program at The Fred Hollows Foundation, said the new Workforce Initiative is key to filling the gap for Aboriginal health professionals in eye heath

“We have a great team here at IUIH and Lauren will have the ability to connect with a number of health professionals, giving her a more holistic look at the patient journey. She will experience first-hand the eye health conditions that affect our people here in south-east Queensland, including the huge impact diabetes is having on the eyes,”

Adrian Carson, CEO, Institute of Urban Indigenous Health, says Lauren will be able to expand her clinical knowledge during her time with the organisation.

A new $40,000 partnership between The Fred Hollows Foundation and the Institute for Urban Indigenous Health (IUIH) will provide optometry student Lauren Hutchinson with hands-on experience in communities in Brisbane in October, and the chance to visit rural communities in south east Queensland later on.

Photo caption: L-R: Brian Doolan (CEO, The Fred Hollows Foundation), John Brumby (Chair of Board, TFHF), Lauren Hutchinson (student), Gabi Hollows (Board Member, TFHF), Adrian Carson (CEO, IUIH)

Ms Hutchinson holds a Bachelor in Visual Science and is a Masters student in optometry at the Queensland University of Technology. A Wiradjuri woman, she was born in Molong NSW and attended St Joseph’s Primary School and Molong Central School (for High School).

Ms Hutchinson will spend three months training with the Aboriginal Community Controlled Health sector, learning on-the-job and through mentoring with the IUIH Regional Eye Health Unit and optometry clinics, as part of a team working in a multidisciplinary Aboriginal and Torres Strait Islander health organisation.

Optometry is a great career that can really make a difference to people’s lives, Ms Hutchinson said. “I’m really looking forward to working with IUIH. It will be such an invaluable opportunity to get some practical experience working with people in their local areas, as well as chance to work alongside some of the leading professionals in Indigenous eye health,” she said.

The Workforce Initiative will support practical placement across the IUIH’s 17 eye health clinics in optometry services and the ophthalmology clinic. As part of the program, Ms Hutchinson will learn about service delivery in rural and remote parts of Queensland.

 

NACCHO #closethegap the gap for vision : $2.5 million in funding to provide continued support to Indigenous Eye Health

HT

“The funding will allow the unit to provide vital services, and also allow them to work with the sector on innovative and collaborative approaches to eye health,” Minister Nash said.

“This continues what has been a strong government commitment to eradicate trachoma in partnership with the pioneering work of Professor Taylor.”

“We will continue to collaborate with the eye health sector to ensure that we are able to eliminate trachoma by 2020, and close the gap in eye health between our Indigenous and non-Indigenous Australians.”

Senator Fiona Nash, Minister for Rural Health Press Release

Picture Above Professor Taylor , Bobbi Campbell Department of Health and NACCHO Chair Matthew Cooke  :The funding provided over three years from July will support the Unit – led by Professor Hugh Taylor – to deliver a range of services.

Read over 20 NACCHO Eye Stories here

The Coalition Government today demonstrated its commitment to eliminating avoidable blindness and vision loss in Aboriginal and Torres Strait Islander people.

Senator Fiona Nash, Minister for Rural Health and Deputy Leader of the Nationals, announced today $2.5 million in funding to provide continued support to the Indigenous Eye Health Unit at the University of Melbourne.

“I am pleased to announce future funding of $2.5 million to build on the achievements made to date to bridge the gap between Indigenous and non-Indigenous Australian eye health,” Minister Nash said.

“This investment brings our total support for Indigenous eye health to $9.1 million, building on our September 2015 investment of $6.6 million.”

Aboriginal and Torres Strait Islander people are two and a half times more likely to report having complete or partial blindness compared to non-Indigenous Australians.

The Indigenous Eye Health Unit provides expert advice and technical support on trachoma control, which is already helping to improve the eye health of Indigenous Australians.

The funding provided over three years from July will support the Unit – led by Professor Hugh Taylor – to deliver a range of services.

These include providing expert advice to the Department of Health, developing Indigenous eye care resources, providing technical support on trachoma control, and undertaking stakeholder engagement and support for the coordination of Indigenous eye care programmes and services.

“The funding will allow the unit to provide vital services, and also allow them to work with the sector on innovative and collaborative approaches to eye health,” Minister Nash said.

“This continues what has been a strong government commitment to eradicate trachoma in partnership with the pioneering work of Professor Taylor.”

“We will continue to collaborate with the eye health sector to ensure that we are able to eliminate trachoma by 2020, and close the gap in eye health between our Indigenous and non-Indigenous Australians.”

The Australian Government funds the current multilateral Trachoma Project Agreement ($16.5 million over four years to 30 June 2017) for trachoma screening and treatment activities, as well as providing funding for the continuation of trachoma control activities beyond 2017.

Funding is also being provided up to 30 June 2017 for the Kirby Institute at the University of NSW, to operate the National Trachoma Surveillance and Reporting Unit (NTSRU).

Previous POST

More than half (54%) of all Australians report having at least one long term eye health condition, with nearly half the population wearing glasses or contact lenses, according to data released today by the Australian Institute of Health and Welfare (AIHW).

SEE EYE HEALTH DATA PAGE

Eye health conditions may be present from birth, may exist as a result of illness or injury, or may have developed over time due to ageing.

PHOTO Above : SEE NACCHO Report Great Progress in Indigenous eye health

‘In 2011-12, almost 12 million Australians reported having an eye health condition, with long and short sightedness the most commonly reported conditions, and there’s been an increase in these conditions in recent years,’ said AIHW spokesperson Mardi Ellis.

Between 2001 and 2012, the proportion of the population affected by long sightedness rose from about 22% to 26%, while short sightedness increased from around 21% to 23%.

The likelihood of having a long term eye condition increased with age, with 95% of people aged 55 and over affected by an eye health condition, compared with 11% of those aged 0-14.

‘Eye conditions were more common among females than males, and much more common among Indigenous Australians than nonindigenous Australians,’ Ms Ellis said.

Aboriginal and Torres Strait Islander people experience higher rates of preventable blindness and vision loss than other Australians, and are more than twice as likely as non Indigenous Australians to have complete or partial blindness.

Aboriginal and Torres Strait Islander Australians are almost one and a half times more likely to have cataracts, but despite this, are less likely than other Australians to undergo cataract extraction surgery.

‘Some improvements have been seen, however cataract extraction among Indigenous Australians has increased from 5.6 per 1,000 population in 2010-11 to 7.3 per 1,000 in 2013-14,while the rate for other Australians remained steady,’ Ms Ellis said.

The AIHW is a major national agency set up by the Australian Government to provide reliable, regular and relevant information and statistics on Australia’s health and welfare.

Get your Message Across to our 302 Clinics and 100,000 Koori Mail Readers

Aboriginal Health Newspaper Closes March 16

 

NACCHO Resources Alert :’Check Today, See Tomorrow’ resources aim to help reduce the incidence of preventable blindness in Aboriginal people

See

‘Check Today, See Tomorrow’ Resources

Diabetes Eye Care

Diabetes along with cataract, refractive error and trachoma accounts for 94% of Aboriginal and Torres Strait Islander people vision loss and represents up to 11% of the health gap. Despite national guidelines recommending that all Aboriginal and Torres Strait Islander people with diabetes have a YEARLY eye check, only 20% have done so. Of those requiring treatment for diabetic retinopathy only 37% have received it.

The ‘Check Today, See Tomorrow‘ resources have been developed by Indigenous Eye Health (IEH) to support the broader program of recommendations and activities within the Roadmap to Close the Gap for Vision to improve eye health outcomes for Aboriginal and Torres Strait Islander people.

The ‘Check Today, See Tomorrow‘ resources aim to help reduce the incidence of preventable blindness in Aboriginal and Torres Strait Islander people by:

  • increasing awareness on the seriousness of diabetes related eye complications, particularly diabetic retinopathy
  • promoting the importance of a YEARLY eye check, and;
  • seeking and following treatment to prevent loss of vision

Health professionals working in primary care in particular are well placed to deliver key eye messages to Aboriginal and Torres Strait Islander people with diabetes and their carers and these resources have been developed to assist them.

Developing the ‘Check Today, See Tomorrow’ Resources

An iterative, engaging, community-driven process was taken to develop eye health promotion messages and resources focusing on diabetes eye care. Community consultations were undertaken in selected regions, partly because of their progress in implementing the Roadmap to Close the Gap for Vision where eye care service improvements are being implemented.

The three communities involved in the development of ‘Check Today, See Tomorrow’ resources reflect the cultural and regional diversity of Indigenous Australia. The communities include urban, remote and rural settings, and are in three states:

  • Deception Bay, South East Queensland
  • Looma Community, Kimberley, Western Australia and
  • The Grampians region, Victoria

The ‘Check Today, See Tomorrow’ resources were created ‘by community for community’ using music, art and sharing personal stories as the backbone for community engagement and participation. This community engagement was integral to understanding the motivation, ability and triggers for behavioural change from community members directly affected by diabetes and/or affected by vision loss from diabetes.

Community engagement also allowed for key themes, slogans, language, design and imagery to be created for the overall ‘look and feel’ of a suite of social marketing resources. The ‘Check Today, See Tomorrow’ resources include a resource kit and series of multimedia resources. The implementation of these resources will be supported by IEH in regions that are currently being engaged under the guidance of the Roadmap to Close the Gap for Vision.

‘Check Today, See Tomorrow’ Resource Kit

The ‘Check Today, See Tomorrow’ resource kit provides a starting point for health services and communities to integrate key eye messages into chronic care plans, programs and exiting social media platforms. The kit can be used as a tool to support health workers, nurses, doctors, diabetes educators and other primary care providers to deliver eye health messages to Aboriginal and Torres Strait Islander people with diabetes and their carers.

The Check Today, See Tomorrow’ resource kit is available to download or order.

IMG_1724_C

Each kit contains:

  • 50 x Diabetes Eye Care Brochures
  • 1 x Diabetes Eye Care Flipchart
  • 2 x Campaign Posters
  • 2 x Key messages/Adult Eye Check Card
  • 2 x Diabetic Retinopathy Screening Card
  • 1 x Diabetic Retinopathy Grading Course Flyer
  • 1 x Social Media Guide

Supporting Multimedia Resources

Supporting the ‘Check Today, See Tomorrow’ resource kit is a series of diabetes eye care:

These are available to view and/or download from our multimedia resources page.

 

For further suggestions and recommendations on how to use social media to implement the ‘Check Today, See Tomorrow’ resources in your health service and community please refer to the How-to-Guide’, or alternatively, please contact IEH for support.

We also encourage further adaptations and tailoring of the resources to help acknowledge and respond to community needs (please refer to the ‘Check Today, See Tomorrow’ Style Guidelines on our website for more information).

If you have any questions regarding the kit, or you require further information or support, please contact us via email or phone (03) 8344 9320(03) 8344 9320.