National Indigenous health equality summit 2008
Fact Sheet 4: Success stories
Australians for Native Title and Reconciliation (ANTaR) produced a report in 2007 highlighting the good news in Indigenous health.
The publication contains success stories that demonstrate that change for the better is possible and highlights the active role that Aboriginal and Torres Strait Islander peoples are seizing in identifying and implementing solutions.
Extracted below are just two case studies from the publication, Success Stories in Indigenous Health – a showcase of successful Aboriginal and Torres Strait Islander successful health projects.
The publication can be found at: http://www.antar.org.au/images/stories/PDFs/SuccessStories/success_stories_final.pdf
Case study 1 - Healthy children: strong futures
Mums and Babies
Program
Townsville Aboriginal and
Islander Health Services, QLD
A major change in the way health care is provided to pregnant Aboriginal and Torres Strait Islander women in Townsville is helping to turn around health outcomes for babies and infants.
Long waiting times and an historically unwelcoming hospital environment had kept many Indigenous women from using mainstream health services during their pregnancy, according to Dr Kathryn Panaretto, Senior Medical Officer with the Townsville Aboriginal and Islander Health Services (TAIHS).
“We wanted to create an environment where women felt comfortable, where they were treated as people and where they could bring children along,” she said.
With pilot funding from the Rio Tinto Aboriginal Foundation and the Ian Potter Foundation, TAIHS established the Mums and Babies program in 2000 – a morning clinic for pregnant women and young mothers, initially staffed by two female doctors, two health workers, a child care worker and a driver.
The popularity of the program was immediate. In the first month of operation, the clinic saw 40 clients. A year later the number had grown to 500 clients each month. Five years later on – and now in a purpose-built family friendly centre – the number of clients continues to grow steadily.
“We’re seeing more pregnant women, we’re seeing them earlier in their pregnancy and we’re seeing them more regularly,” says Dr Panaretto. “Having this sort of consistency means you can build a relationship with the women and talk with them about issues like smoking, alcohol and healthy eating.”
According to the Australian Medical Association, Indigenous babies are more than twice as likely to be born premature or underweight as non-Indigenous babies, placing them at higher risk of developing chronic illness such as heart disease, kidney disease and diabetes later in life.
The major contributing factors to low birth weight babies include smoking, alcohol, sexually transmitted diseases and malnutrition in the mother.
However, after only five years, the health outcomes for Indigenous babies and infants in Townsville have improved markedly. There has been a reduction in low birth weight babies from 16 per cent to 11.7 per cent; mean birth weights have increased by 170 grams; and perinatal deaths have fallen from 58 per thousand to 22 per thousand.
Word of mouth about the Mums and Babies program has been so positive that now one third of all women using the service come from outside of Townsville, says Melvina Mitchell, the acting Program Coordinator.
“We recently had a customer satisfaction survey and the feedback was all positive – the women told us they feel really comfortable coming here, and the kids have a great time too. We’re even seeing fathers bringing their kids in,” she said.
According to Melvina, the attitude and commitment of the staff is the major reason why the program works so well. “The people who use the service like the fact that most of the staff here are Indigenous and they like seeing the same faces when they come in,” she said.
A number of ancillary services have been established to support mothers and young children, including programs to encourage breastfeeding, provide nutrition support, increase immunisation rates and monitor healthy child development, says Dr Panaretto.
“If you’ve got a good model of health care, then people will feel comfortable coming to see you,” she says.
“That really goes to the heart of what we’re doing here – trying to build a culture of using health care among the local Aboriginal and Torres Strait Islander community.”
Case study 2 - Nutrition: at the heart of good health
Chronic diseases such as diabetes and heart diseases are the principal causes of early death among Aboriginal and Torres Strait Islander peoples. Health professionals agree that improving diet and nutrition is a fundamental starting point to tackling these problems.
Removing barriers to obtaining healthy food and promoting healthy nutrition among Indigenous families are key goals of the National Aboriginal Torres Strait Islander Nutrition Strategy and Action Plan 2000-2010.
The Action Plan notes that many Aboriginal and Torres Strait Islander people, particularly those living in remote areas, do not have the same opportunities as other Australians to obtain affordable and healthy food. In some remote communities food can be up to 150% -180% more expensive than in the major centres.
The aim of the Action Plan is to support communities to develop and deliver effective healthy lifestyle programs in a broad range of settings, such as childcare centres, cultural and sporting events, schools and aged care services.
The Action Plan is built on research into successful nutrition and health programs in Indigenous communities, which highlight the following ‘good practice’ elements:
- community involvement and support at all stages
- empowering the community rather than imposing priorities on the community
- multifaceted interventions
- monitoring and providing feedback to participants
- modifying strategies according to need.
Read more: National Aboriginal Torres Strait Islander Nutrition Strategy and Action Plan 2000-2010
Jalaris Aboriginal Corporation, WA
“Relationships are at the heart of everything we do,” says Brett Morris, who heads up the Jalaris Aboriginal Corporation in Derby, in the far north of Western Australia.
“Family and community is the same thing here,” he says. “We live in the community, we work in the community. Our kinship with the community is the most important thing we have. We wouldn’t be able to achieve anything without the trust and respect of the people.”
Since 1994 Jalaris has been helping to improve health and nutrition levels in Derby, with a particular focus on boosting child nutrition.
Brett and his wife Biddy began by operating (voluntarily) a low-cost food and clothing store. This was followed by a commercial kitchen to provide cheap meals for the community.
The high level of demand on the kitchen showed a widespread community need for affordable, healthy meals.
In 2002 Jalaris received funding from the National Stronger Families Fund to establish a Drop-In Centre to provide healthy meals to children and young mothers.
“The Drop-In Centre was really successful at changing kids’ attitudes to healthy food,” said Brett.
“When we gave kids a stew they would eat the meat but then chuck the vegetables on the floor. Within twelve months they were eating everything we gave them.
“And of course we saw immediate changes in the physical health of the children. They were more attentive and the infections and runny noses started to clear up.”
However, there was a growing concern among Jalaris staff that the parents weren’t attending with their children.
“Parents were dropping the kids off for child minding and then going elsewhere,” says Maya Haviland, who has worked with Jalaris for many years. “We saw that we needed to work more closely with families to provide education around nutrition and healthy eating.”
This included setting up a Women’s Room in the Centre and running cooking classes and working with TAFE to provide a short course in nutrition. In 2004 - in association with Derby Aboriginal Health Service - Jalaris established a mobile nutrition and health van to visit and support families in the community.
“Early intervention looks different in a place like Derby,” explains Maya. “In this community, early intervention is making sure families and children have food to eat. Seeing that the food gets to kids is our first priority.
“What we do is a necessary ‘grass roots’ response to the situation, but sometimes that can be hard to explain to a government agency that only wants to fund a ‘top down’ approach.”
By building strong relationships and meeting the needs of families and children, Brett, Biddy and the Jalaris staff have seen real changes take place.
“Kids now come into our home looking for a piece of fruit or a glass of cold water,” says Brett. “And kids who used to truant now come to us at 7.30 in the morning – we give them some breakfast and then they ask if we’ll take them to school.”
Despite its successes, the long-term future of Jalaris remains unclear. Short-term and uncertain funding makes it difficult to develop and retain skills in the community to do this work.
“Sustainability is very important – without that we’ve got no hope,” says Brett. “My wife Biddy and I are not getting any younger so we need people to take over from us. We need reliable funding so we can train local Indigenous people and pay them proper wages, otherwise they’ll leave”
“A number of local young women would like to being trained up and work with Jalaris,” adds Maya. “It’s absolutely critical to invest in motivated young people and build community capacity to tackle its health problems.”
Also see: Oxfam Australia and the National Aboriginal Community Controlled Health Organisation’s briefing paper Close the Gap - Solutions to the Indigenous Health Crisis facing Australia at www.oxfam.org.au/media/files/CTG.pdf
