30/8/08
Batchelor Institute is Australia’s only indigenous dual sector tertiary education provider and fulfils a vital role in the education of Australia’s original inhabitants while also helping non-indigenous people provide services and support to this area. The Institute’s ‘both-ways’ learning philosophy is based on respect and brings together traditional indigenous knowledge systems with Western academic disciplines to provide students with pathways to successful learning journeys. Course delivery is specifically tailored to meet the needs of Aboriginal and Torres Strait Islander people, especially those from remote communities where English is often a second or third language and cultural traditions are strong.
The Australian, No Internet Text; Australia, Aboriginal, Education; Special Advertising Report [6 Articles]
Based in the Northern Territory and with a special focus on remote NT communities, Batchelor Institute attracts students from across Australia to its facilities south of Darwin and in Alice Springs.
Batchelor also has annexes in Darwin, Tennant Creek, Katherine and Nhulunbuy, plus purpose-built study centres in seven remote NT communities: Borroloola, Arlparra, Nyirrpi, Maningrida, Minjilang, Ngukurr and Gunbalanya.
An example of the Institute’s innovative approach is the unique joint venture between Batchelor, Frontier Services and the NT Department of Health &
Community Services that will allow health workers in Tennant Creek to study locally for a Bachelor of Nursing degree.
Frontier Services runs an aged-care facility at Tennant Creek and approached Batchelor Institute with the idea because of ongoing difficulties attracting registered nurses to the remote location.
The carers at the facility, who are both indigenous and non-indigenous, believed the solution was to get their own nursing qualifications, but they did not want to leave the area.
“The support from Batchelor Institute in offering the service locally and accepting non-indigenous students has been fantastic, and the nursing degree is an excellent course,” Frontier Services spokesperson Sandre Buckley said.
Batchelor Institute deputy director Tom Evison said it was the first time the Institute had been able to expand remote-area training to include non-indigenous students who are involved in providing health services mainly to indigenous people.
“This more flexible approach follows a decision by Batchelor Institute Council to respond to requests from remote communities to adapt our off-campus training to serve mixed indigenous/non-indigenous workplaces in particular situations,” he said.
The initiative aims to produce nurses who are competent for general nursing practice and eligible for Australia-wide registration, enabling them to be employed in a diverse range of institutions and remote communities, and help to meet the demand for nurses in the NT.
Maari Ma takes lead with prevention strategy
30/8/08; The Australian, No Internet Text; Australia, Aboriginal, Health; Special Advertising Report
Prevention is the key to the positive results of the Maari Ma Health Aboriginal Corporation in far western NSW. Its policy for improving Aboriginal health is to tackle the problems before they occur. It works with Aboriginal communities to make health services accessible and acceptable to them. For more than 10 years the corporation has worked with the state government to manage health services in the state’s Lower Western Sector, now called the Maari Ma region.
The Lower Western Sector Agreement is the first enabling an Aboriginal organisation to have direct input and management of state-owned health services.
Two years ago the corporation developed a chronic disease strategy in response to the concerns of the Aboriginal board of directors. Its priority is the prevention and management of chronic illness.
The policy involves the region’s health service providers — the Greater Western Area Health Service, the Royal Flying Doctor Service and Sydney University’s Department of Health.
Maari Ma has taken a lead in health services in the National Audit and Best Practice of Chronic Disease (ABCD). This is a continuous improvement project funded by the Co-operative Research Centre for Aboriginal Health (CRCAH) and managed by the Menzies
Research Institute in Darwin. The project works with health groups to identify strengths and weaknesses in their systems, set goals for improvement and assess the effectiveness of strategies to improve key aspects of primary health care.
In June, Maari Ma was recognised with an award at the annual ABCD planning conference held in Cairns.
According to Maari Ma director Richard Weston: “The ABCD project has helped us measure the effectiveness of our work.
“We have been able to measure improvements in management of blood sugar levels, blood pressure and indicators of renal disease in our clients.”
Fighting fear to lift cancer survival rates
30/8/08; The Australian, No Internet Text; Australia, Aboriginal, Health; Special Advertising Report
Analysis: QIMR scientists showcase the institute’s indigenous health career path to high school students; Laura Cencigh-Albulario
Leaving their remote community behind, travelling to a sterile hospital in an unfamiliar city and receiving treatment that makes them feel sicker are frightening experiences for many indigenous cancer patients. Fear and lack of awareness about cancer treatment are part of the reason that cancer survival rates are so low among indigenous Australians. Although the incidence of cancer in indigenous Australians is similar to that of the general population, Cancer Registry records show the death rates of indigenous people with cancer are up to 45 per cent higher.
The Queensland Institute of Medical Research (QIMR) is currently analysing data from a comparative study. of treatment and health care services for indigenous and non-indigenous cancer patients in Queensland.
Ranging from 1998 and 2004, the data takes into account the cancer stage, type, location of residence, and the impact of comorbidities — or other diseases — on the results. Most indigenous cancer patients have varieties with lower survival rates such as lung and liver cancer. Rates of cancers with better survival odds, such as melanoma, are extremely low in the indigenous population.
QIMR Indigenous Health Research Program epidemiologist Patricia Valery said even after adjusting for factors such as cancer stage and type, mortality was still higher for indigenous compared to non-indigenous Queenslanders.
“When we compared the data, we took that into account as well as the stage of diagnosis, other diseases and remote locations,” Dr Valery said.
“There are more comorbidities, but even after testing for that, there’s still a gap. “This suggests that outcomes from treatment are poorer.” While the full analysis of the findings won’t be complete until December, researchers expect the gap to be related to access to health services, patients not receiving treatment in a timely manner and failure to follow through and complete the prescribed course of treatment.
“Things which possibly influence people not getting the proper treatment is that (while at hospital) they miss their family, they miss the land, they go back for a while, they don’t have the money for transport to come to the city for treatment, and they feel frightened, they feel it’s a hostile environment,” Dr Valery said.
“The medication makes them sicker, their reaction to it might be different than non-indigenous people.More are seeing doctors that aren’t specialists because they’re from remote areas, there might be language barriers, they don’t understand exactly what’s going on with them and the explanations that are given are not clear to them.”
QIMR now intends to conduct a Supportive Care Needs Survey to explore the methods of boosting cancer survival rates among the indigenous population. It is also seeking funding to run an Indigenous Navigator Project, to be piloted over three to four years.
This will involve patients being matched up with a health worker to ‘navigate’ them through their cancer treatment, connect them with specialists and ensure they have the necessary follow-ups.
“If the problem of poor survival is about access to treatment and services, this will help, as there are a lot of services out there that indigenous people don’t know about,” Dr Valery said. “It’s not about creating extra services, it’s about trying to get them to access the services that are already available.”
Some hospitals in Queensland, such as the Royal Brisbane Hospital, already have an indigenous liaison officer to assist indigenous patients once they visit the hospital.
But Dr Valery said patients with cancer required a special level of care: “Cancer usually involves a long and intensive treatment, patients have to go to hospital quite often, and there are lots of side-effects from the medication.
“Especially for patients whose prognosis is not good and the likelihood of dying is high, they need a lot of psychological support as well.”
Cultural understanding is the key
Annabel McGilvray; 30/8/08; The Australian, No Internet Text; Australia, Aboriginal, Health; Special Advertising Report; www.healthinfonet.ecu.edu.au
Chronic disease and the more than 17-year gap in life expectancy are the headline-grabbing symptoms, but it’s poor access, poor information, and the need for better cultural understanding that are the fundamental problems afflicting indigenous health in Australia today. In one example from the reams of crushing statistics, rates of kidney disease are now on average nine times higher among Aboriginal and Tones Strait Islanders than non-indigenous Australians and up to 25 times higher in the Northern Territory.
Other figures show that indigenous men die from heart disease, stroke and other forms of cardiovascular disease at a rate more than three times that of the non-indigenous population, and that’s widely considered to be an underestimate.
However, Australian Indigenous Doctors Association (AIDA) president Dr Tamara Mackean says that, to begin reducing such horrendous rates, it’s necessary to look beyond simply providing more doctors to treat the failing kidneys and other conditions.
“Look at the things that need to be done from a strict biomedical paradigm around treatment, drugs and/or transplants, early intervention, putting people on ACE inhibitors, having a public health approach in terms of nutrition and general wellness,” Mackean says.
“But unless you actually go further back and understand issues of trauma, grief and loss and
understand those things on a generational basis, and then also understand the position of Aboriginal people in society and what that means for their health and wellbeing . . . we’re really not going to get a long way forward.
“We, can supply as many doctors as we like, but until we understand how racism influences people’s health and welfare and how issues of trauma influence people’s health and well-being, then we’re just going around in circles.”
In Bunbury, in the very south west of Western Australia, the biggest health problem facing the South-West Aboriginal Medical Service (SWAMS) is diabetes, one of the leading causes of kidney disease.
It’s a similar story at most of the nationwide network of Aboriginal medical services. However at SWAMS, in an effort .reduce the incidence of diabetes and address other common health problems, a series of innovative programs have been introduced to help the service improve access and become more culturally relevant.
These efforts were recognised at a ceremony in Melbourne last night where SWAMS received a prestigious National Indigenous Governance Award for its approach, which includes programs to provide health services in the local indigenous language, offer traditional medicines and work with the community’s elders.
“We’re trying to introduce the Nyoongar language into our workforce,” SWAMS chief executive officer Glenda Humes says.
“And we’re holding a traditional healing conference where we’ll be talking about the healing practices that Nyoongar people have been practicing for a very long time and how we introduce that into our service.”
The success of similar efforts can be seen at Brisbane’s Inala Community Health Care Centre, where moves to employ indigenous health workers, create culturally appropriate information brochures and interact with the indigenous community saw the number of clinic visits grow from less than 1000 in 1995, to more than 6000 a decade later.
Given the effect an indigenous health worker can have in improving cultural understanding, the continuing small numbers is a substantial handicap.
There are only 110 Aboriginal and Torres Strait Islander doctors Australia-wide, working across many different specialisations. The scarcity of indigenous doctors and other health workers makes it more difficult to change culturally inappropriate practices in health centres and hospitals. The result is that, even when healthcare is geographically accessible, for many indigenous people it remains culturally inaccessible, says Mackean.
A further issue is the lack of the accurate information and statistics, which are vital for devising policies and projects to improve health conditions.
A stark example is the fact that the Australian Bureau of Statistics’ rates of Aboriginal and Tones Strait Islander mortality are still based on figures from the Northern Territory, Western Australia, South Australia and Queensland only. They don’t include Aboriginal deaths in Victoria, the ACT, Tasmania and even NSW, the state with the largest Aboriginal population.
Further distorting figures, between 2002 and 2006 only 55 per cent of indigenous deaths were correctly identified as being indigenous when it came death registrations. Calculations are made by to account for this, but the result remains questionable says Mackean.
She points to the predominantly government-funded website, Australian Indigenous HealthlnfoNet, as an important reference hub for information with relevant contextual qualifications relating to the whole range of Australian indigenous health issues.
In addition to statistical information it offers links and information regarding projects around the country addressing issues such as nutrition, alcohol misuse and social and emotional well-being. The site provides a reference point for everyone working in indigenous health, from Aboriginal healthcare workers to academics and policy makers.
HealthlnfoNet is grim reading today, but on the eve of AIDA’s 10th birthday next month, Mackean, Humes and others are optimistic that mainstream understanding of the issues facing indigenous health is increasing. In turn that understanding is gradually leading to improved approaches to indigenous healthcare, and eventually, it is hoped, better health for Australia’s Aboriginal and Tones Strait Islander community.
Looking to the kids in effort to close the gap
30/8/08; The Australian, No Internet Text; Australia, Aboriginal, Health; Special Advertising Report; For more information, go to www.action.nt.gov.au.
The standard of health amongst indigenous Australians across the country is a national disgrace but an innovative approach to the problem in the Northern Territory may set a precedent for the best long-term solution to the problem — by investing in the future. Closing The Gap is the NT Government’s program to cut back the level of disadvantage experienced by indigenous residents and the health initiatives contained within are a central plank.
The program focuses on children under five, a group that NT Chief Minister Paul Henderson said possessed the most potential for creating a long-term and lasting positive change in the health and status of indigenous Australians in the region.
“It is a generational plan of action, recognising that the disadvantage faced by indigenous Territorians cannot be solved overnight,” he said.
“We must aim for the children being born in the next few years to live healthy lives from their earliest years if they are to take advantage of going to school, getting good and satisfying jobs, and raising families themselves.”
Indigenous children in the Territory are more than twice as likely as non-indigenous children to die before the age of one while life expectancy at birth is 16 to 20 years lower for indigenous Territorians than non-indigenous.
Non-communicable diseases, such as heart disease, diabetes and cancer account for almost 80 per cent of the gap between indigenous and non-indigenous life expectancy, with poor access to primary health care services also responsible for disparity.
A central plank of Closing The Gap is the implementation of integrated early childhood and family services in communities, at a cost of $9.6 million, with
the establishment of family centres in remote communities, delivery of programs around antenatal care and maternal health and a focus on strengthening the development and learning of pre- schoolers through child care and early education services.
Another $4.5 million will go towards providing sport and recreational officers, facilities and programs in each shire with a view to improving sport and recreational facilities in remote communities and promoting the importance of sport and recreation to a healthy lifestyle in education programs and curriculum.
The plan also calls for an investment of $500,000 in alcohol and drug rehabilitation services in remote communities by supporting clinical interventions in acute settings, establishing a new facility in Darwin to provide residential withdrawal, and providing additional clinical resources in Darwin and Alice Springs to support community-based and residential withdrawal capacity.
The final step, at a cost of $8.8 million, is the expansion of programs targeting hearing loss and preventable chronic diseases, including diabetes, through earlier identification, best practice management and monitoring.
Deputy Chief Minister Marion Scrygmour believes the building blocks of the program — education, health and safety — are interdependent and all outcomes are of top priority.
“We are also working — as a priority — to work with families to support kids in those vital early years through improved health care and pre-schooling so they will be ready for school when they are old enough,” she said.
Crooner and rock star tackle kidney disease
30/8/08; The Australian, No Internet Text; Australia, Aboriginal, Health; Special Advertising Report;
They make an unusual two-man band: Graham “Buzz” Bidstrup, drummer with legendary rock act The Angels, and 1960s pop singer turned country entertainer Jimmy Little, called the grandfather of Aboriginal music. But while the rock star and the crooner have enjoyed a long professional association, their most stirring collaboration is not musical but medical — working together in the Jimmy Little Foundation to raise awareness of the kidney disease epidemic ravaging Aboriginal and Torres Strait Islander communities.
It is a very personal issue for 71-year-old Little, who in 2004 received a kidney transplant after two years of lifesaving dialysis. And it has become one for his manager and great friend Bidstrup, who also plays in Little’s live band and still rocks with The Angels and his other group, Gangajang.
Their partnership began in 1999, when Bidstrup helped with the release of Little’s hit album Messenger. The album went gold and thrust the semi-retired singer-songwriter back into the music scene.
“It went nuts, so we had a little discussion,” Bidstrup says. “I wasn’t sure if I wanted to be a manager and said I’d give it a go for six months.”
They have been combing the country together ever since, most recently touring the Northern Territory. In early August they met up with Mandawuy Yunupingu at the Garma Festival of Traditional Culture — but the Yothu Yindi frontman was too sick to play. Last year he publicly revealed he was suffering from renal failure and he remains on dialysis.
Little, despite facing a lifetime of anti-rejection drugs, is one of the lucky ones. Indigenous Australians have a life expectancy about 17 years less than the national average, according to statistics provided by the Jimmy Little Foundation (JLF). In some remote communities the incidence of kidney failure is up to 50 times the national average and accounts for more than a third of Aboriginal deaths. Yet about half of sufferers live in areas with no dialysis facilities and are forced to make gruelling road trips, or even move, to get treatment.
“It’s a monstrous problem,” says Bidstrup. ‘We just went to Nhulunbuy, to Oenpelli in Arnhem Land, to Kakadu and the Tiwi Islands. There are no dialysis facilities in most of these areas. In places like Jabiru and the outstations in Kakadu National Park, if you have kidney failure you have to drive, or get someone to drive you, into Darwin three times a week to dialyse. If you live in Mutitjulu you have to move to Alice Springs.”
He reckons dialysis machines are needed in about 50 remote communities. At about $70,000 apiece, he says that would come to a fraction of the cost of last year’s federal government intervention to address child sexual abuse in Northern Territory Aboriginal communities.
“The amount of money spent in the first few weeks of the intervention would have upgraded every Aboriginal health centre around the country to state of the art, including putting dialysis machines in every community,” he says.
While that remains the ultimate dream, as an interim measure the JLF is working with the Alice Springs dialysis centre, dubbed the Purple House, on the Return to Country program, which enables kidney patients tethered to the town by their treatment to make short visits home.
“Some people have lived in Alice Springs for two years and never go back home,” Bidstrup says. “That is what is heartbreaking. They have to leave their land, their dreaming, and that is everything to them. And in the communities, the elders disappear.”
After two years spent fundraising, meeting with community groups and government agencies and forming alliances with other health providers, such as the Fred Hollows Foundation and Diabetes Australia, Bidstrup and Little are kicking their campaign into a higher gear, seeking donations (see details at jlf.org.au) and pressing for more public funding. “It’s time for serious action,” says Bidstrup.
Little believes the campaign is one of the reasons fate brought him and Bidstrup together. “I’m a believer that 90 per cent of my life and career was preordained. It was destiny that people came into my life at different intervals and journeyed me along this great path,” he says.
“I’m a prime example for patients in all areas, urban, rural and regional, to not give in, not retire from life. There is help, there (are) people with passion, there is money out there, and we’re just trying to channel that.”
Tags: Aboriginal, Australia, Education, health