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Welcome to the twelfth edition of Gwalwa-Gai, the newsletter for the CRC for Aboriginal Health. Gwalwa-Gai is an expression used by Larrakia people to call clan groups together. This edition of the newsletter features a guest editorial by Waanyi man and medical anthropologist, Gregory Phillips on the critical challenges being faced by Australian medical schools in addressing the huge health inequities suffered by Aboriginal people. What are our medical schools doing to ensure greater enrollments from Aboriginal students? How are they improving the understanding of Aboriginal ill-health and the sensitivity to Aboriginal cultural security by medical graduates? Gregory Phillips' editorial sheds some light on these critical questions. Please forward this newsletter on to others who may be interested. To subscribe go to: www.crcah.org.au. |
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Guest editorial writer for this edition of Gwalwa-Gai is Gregory Phillips a Waanyi man and medical anthropologist who previously worked with Medical Deans Australia and New Zealand to develop their Indigenous health curriculum framework. Gregory currently consults in Aboriginal and Torres Strait Islander health as Executive Director of ABSTARR Consulting. In this editorial Gregory Phillips reports on the challenges faced by Australian medical schools to increase Indigenous student enrolments and to develop curricula that will improve on non-Aboriginal graduates' understanding of Aboriginal health and their skills to address the continuing gap in health outcomes…. Indigenous health workforce development: the role of medical schools Among the family of health disciplines, medicine is one of the most influential. While the bio-medical model does not offer a solve-all for the health issues confronting Aboriginal and Torres Strait Islander Australia, it certainly is one of the key groups that must engage with and take responsibility for ending health inequity. Australia's nineteen medical schools have made some significant advances in recent years in terms of Indigenous health. They have developed a nationally accredited curriculum framework, endorsed changes to accreditation standards, and signed an Agreement for Collaboration with the Australian Indigenous Doctor's Association (AIDA). But will this guarantee changes to graduates' knowledge, skills and attitudes? Will the changes guarantee a significant increase in the number of Aboriginal and Torres Strait Islander medical students and graduates? Most critically, will it have a positive impact on Indigenous health outcomes? It is of course too early to comprehensively answer any of these questions. The impact of changes to curriculum depends very much on the capacity of a medical school and its staff to adequately implement curriculum. For example, will a senior non-Indigenous clinician in a teaching hospital themself have the necessary knowledge, skills and attitudes to be able to teach adequately? Challenges remain in ensuring quality and consistency in this area, and it is one the medical colleges, divisions and professional organisations may need to play a role in. Whether medical schools will be able to create innovative marketing and recruitment programs for Indigenous student intakes remain to be seen, although there are some excellent examples of note where it has been done successfully (see www.limenetwork.net.au ). It should be noted however, that these universities have often managed to increase or maintain their Indigenous student intake on meagre resources, and some have relied, sometimes unfairly, on the extra blood, sweat and tears of their Indigenous staff. Vague commitments need to transform into action in some medical schools. What will it take for Australia as a nation to ensure Indigenous health workforce development? Although important, leaving recruitment to medical, nursing or physiotherapy schools only is not enough. The Commonwealth and the States and Territories should seriously invest resources to ensure Indigenous students are encouraged to dream in primary school, are supported academically, financially and culturally the whole way through their education, and that education institutions reform their whole operations to be culturally inclusive, rather than relying on ticking boxes at accreditation time. All that said, Medical Deans Australia and New Zealand as an organisation, along with some individual medical schools, have shown exemplary leadership on Indigenous health workforce development. Now is the time to drive home those commitments with specific focus and resources. As a nation we must ensure non-Indigenous health professionals are comprehensively trained, and that we recruit and graduate every Aboriginal and/or Torres Strait Islander doctor and health professional possible. As AIDA graduates have already shown, Indigenous doctors' don't think they know it all; they work respectfully with our people to create healthier families and communities. More of them please!gregory@abstarr.com |
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| Dental disease increasing - new AIHW report | CRCAH to present key research findings to Federal Parliament | ||
A new report published by the Australian Institute of Health and Welfare has found that Aboriginal children are “disadvantaged in terms of oral health.” Oral health of Aboriginal and Torres Strait Islander children published in December 2007 provides a summary of Aboriginal and Torres Strait Islander child oral health using information from the Child Dental Health Survey, the Aboriginal and Torres Strait Islander Children and Receipt of Hospital Dental Care Investigation and the Study of Aboriginal and Torres Strait Islander Child Oral Health in Remote Communities. Throughout the states and territories studied, Aboriginal and Torres Strait Islander children had consistently higher levels of dental disease in their infant and permanent teeth than their non-Aboriginal counterparts. Aboriginal children most affected were those in socially disadvantaged groups and those living in rural/remote areas. Trends in Aboriginal child caries (a demineralisation of the tooth surface caused by bacteria) prevalence indicate that dental disease levels are rising, particularly in infant teeth. Aboriginal children aged under 5 years had almost one-and-a-half times the rate of hospitalisation for dental care as other Australian children, and the rate of Aboriginal children receiving hospital dental care rose with increasing geographic remoteness. Less than 5% of remote Aboriginal pre-school children reported brushing their teeth on a regular basis and many young remote Aboriginal children experienced extensive destruction of their deciduous teeth. Improving the oral health of Aboriginal and Torres Strait Islander children in Australia is an important public health and dental service provision issue. To see a copy of the report: Click Here * see article on the Strong Teeth for Little Kids project in the research section of this Gwalwa-Gai. |
As part of efforts to ensure Aboriginal health policy is informed by high-quality evidence the CRCAH is taking a number of crucial research projects to Federal Parliament on March 13. The Parliamentary Aboriginal Health Research Showcase will see four major projects presented directly to politicians, their advisers, senior bureaucrats and Canberra non-government health organisations. The Prime Minister, Kevin Rudd, has been invited to formally open the event which will feature presentations from;
A web page with further details of the planned showcase is under construction at www.crcah.org.au If you live in Canberra and would like to attend the Showcase please contact Cassandra.preece@crcah.org.au |
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At a recent Brisbane meeting of Commonwealth, State and Territory treasurers and health ministers the treasurers affirmed the importance of measuring the cost-effectiveness of Indigenous programs, including health, as a means of informing better policy making in Indigenous affairs. According to the ministerial council communiqué, “Treasurers agreed that all jurisdictions will cooperate in the development of a national framework for reporting expenditure on Indigenous services.” The communiqué said that “the focus will be in relation to on-the-ground services.” "The national framework will comprise expenditure by all jurisdictions, at both Commonwealth and State/Territory levels, and will seek to include both Indigenous- specific and mainstream spending on services for Indigenous Australians in areas such as education, justice, health, housing, community services, employment, and other significant expenditure. “The national framework will cover spending in relation to all funding sources, not just funding arising from the Commonwealth Grants Commission equalisation process.” A report in accordance with the national framework will be provided to the Council of Australian Governments (COAG) annually, and an initial ‘stock take' report will be provided for the first COAG meeting in 2009. “The Commonwealth will consult with agencies such as the Productivity Commission, the Australian Institute of Health and Welfare, and the Australian Bureau of Statistics to determine their interest and possible contribution to developing the national framework, as well as possible ongoing involvement in the process.” Jurisdictions are providing to the Commonwealth feedback on issues discussed at the meeting, other issues they consider need addressing in this sub-program of work, and any background information regarding current jurisdictional reporting processes. A further paper will be prepared by the Commonwealth Treasury and interested jurisdictions, outlining methodological issues and a forward work plan, for consideration by the Indigenous working group ahead of the March 2008 COAG meeting. |
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Australia 's peak nurses union has called for greater government consultation with the Aboriginal health sector and communities in developing policies to close the health disparity gap. The Australian Nursing Federation (ANF) wants to see the Council of Australian Governments (COAG) engage with Indigenous health professionals and community leaders when focusing on health equality for Indigenous people. ANF made this request before COAG's recent meeting in Melbourne . Indigenous affairs, especially health issues, is a prominent agenda item for this peak intergovernmental forum in 2008 and beyond. ANF also sought additional scholarships for Indigenous people to undertake nursing courses and extra resources for Indigenous maternal and child services. ANF Federal Secretary Jill Iliffe said, “COAG's decisions are critical for the delivery of an equitable, efficient, quality health care system for all Australians, including Indigenous people." According to the ANF, the COAG meeting presented an opportunity to comprehensively address the significant issues facing health care provision and health care workers in Australia. “Nurses have welcomed the Federal and State Labor Government's unified and consultative commitment to a whole of health approach,” Jill Iliffe said. The ANF represents about 150,000 members and is the professional and industrial voice for nurses and midwives in Australia. |
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A one and half day sexual health forum is being planned for February in Alice Springs The Forum, hosted by the National Centre in HIV Epidemiology and Clinical Research (NCHECR), Aboriginal Medical Services Alliance of the NT (AMSANT) and the Department of Health and Community Services, aims to:
Titled the Northern Territory Sexual Health Research and Monitoring and Evaluation Forum the meeting is a response to unacceptably high rates of bacterial sexually transmissible infections in the NT and will discuss approaches for monitoring and evaluating sexual health programs including a proposed large scale research project that may become available to the region if there is support from communities for the project and NHMRC funding becomes available. The forum is being planned for the 14th and 15th February at the Centre for Remote Health in Alice Springs. For further information contact James Ward of NCHECR on 02 93850900 or 0424885495 or Graham Dowling or Dr Liz Moore of AMSANT or Kirsty Smith DHCS on 08 89517553. |
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| Review of Cooperative Research Centres Program welcomed | ||
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Senator Kim Carr, Minister for Innovation, Industry, Science and Research, recently announced a review of the Cooperative Research Centres (CRC) Program as part of a broader review of the national innovation system. The CRC for Aboriginal Health (CRCAH) welcomes the review, as it reinforces the new government's policy of supporting research and innovation based on the “public benefit” criteria. The CRCAH sees the review as a providing an impetus for the rebirth of “public benefit” research and for evidenced-based policy in Indigenous health. Announcing the CRC review, Senator Carr said, "The Rudd Government is absolutely determined to restore public benefit as one of the primary objectives of the CRC Program. This basic principle was stripped away by the Howard Government and it will definitely apply again from the next funding round.” “The review will be comprehensive and will consider all aspects of the CRC Program. It will examine the overall strategic direction of CRCs, looking at the full range of issues, including governance and program design issues, the level and length of funding needed to support the program's objectives, as well as its overall scope and effectiveness,” Senator Carr said. "The Terms of Reference for the wider review of the National Innovation System are broad ranging and will ensure a thorough and complete review of all elements of the CRC Program is carried out," Senator Carr added. Senator Carr said that central to the National Innovation System review would be to examine the bewildering array of government innovation and industry assistance programs. "At last count there were 169 programs in Australia, across all levels of government, aimed at supporting innovation," Senator Carr said. "The review will allow the Rudd Government to work with the States and Territories to streamline these programs, reducing fragmentation and improving effectiveness.” The wide ranging review of Australia's National Innovation System will conducted by an expert panel chaired by Dr Terry Cutler. Dr Terry Cutler, is a highly regarded expert on innovation and industry policy. He is currently a Director of CSIRO and Chair of the Advisory Board for the Centre for Excellence for Creative Industries. The panel will include Professor Mary O'Kane, who will be charged with the specific task of reviewing the Cooperative Research Centres Program. Professor O'Kane has extensive experience in high technology, commercialisation, national research strategies and higher education policy. Stakeholder participation in the CRC review will be central to its success, and Professor O'Kane will be announcing in the next few weeks how interested parties can contribute to the review process. The CRCAH intends to present a comprehensive submission to the review arguing that the current CRC program, with its emphasis on commercialisation of research outcomes and a limited 7-year funding cycle does not well serve “public benefit” CRCs like the CRCAH. Initiated by the Hawke Government in 1990 the CRC Program provides funding to develop collaboration between industry, Australian universities and public sector research agencies to develop innovative research concepts into useable products and processes. Across the program's lifetime, 168 CRCs have been funded (including 58 current CRCs), with the Commonwealth committing nearly $3 billion to the program since its inception. For more information on the Review of the National Innovation System and the CRC Program review, visit http://minister.innovation.gov.au
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First woman president for Congress |
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The CRCAH congratulates Arrente woman, Helen Kantawarra, who recently became the first woman president of CRCAH partner, the Central Australian Aboriginal Congress. Helen has been on the Congress board of the for the past seven years and says she is proud to be following in the footsteps of her father Benno Davis, who helped set up the congress. "He realised that our people needed a special community-controlled health service to service our people and I guess I'm just carrying on his dream and so far, as far as achieving it, achieving the presidency, yes, but there's still a long way to go," she said. |
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| An anonymous donor has pledged $10 million to the University of Sydney to improve services in remote communities. The funds will be used to establish a new Centre for Indigenous Health, which will send doctors and other health workers to rural communities to conduct "fly in, fly out" clinics. The centre also aims to boost the number of doctors and health workers specialising in indigenous health by sending medical, nursing and other students out to the communities for two-week stints in the hope some will develop a career interest in the sector. The new centre will also conduct research on which programs work best to improve indigenous health, to guide government policy. Initially restricted to 12 clinic visits in the the western NSW towns of Broken Hill, Dubbo, Bourke and Brewarrina the program will be will be expanded nationwide. A 10 seater plane will be used to transport health workers to the remote clinics with two of the seats reserved for medical and health students, meaning that about 25 per cent of the university's 270-strong annual medical intake will be offered a trip. The university's dean of medicine, Bruce Robinson, said the project was "very exciting" and the unnamed donor "has made it pretty clear he wants action". "He just feels very concerned, as an Australian, that Indigenous people have such poor health outcomes compared to non-Indigenous Australians, and he wants to do something about it," Professor Robinson said. Professor Robinson said the university was already planning meetings with Deputy Prime Minister Julia Gillard, Health Minister Nicola Roxon and Indigenous Affairs Minister Jenny Macklin to discuss the plans. The university said it would look to federal and state governments for support "to enable this to go national" if the planned evaluation showed it worked. An expansion would be done in conjunction with interstate medical schools that wished to be involved. |
The Royal Australian College of General Practice has welcomed recent comments made by the Minister for Families, Housing, Community Services and Indigenous Affairs, Jenny Macklin, committing the Rudd Government to consult more closely with the Aboriginal and Torres Strait Islander community on the Northern Territory intervention. A recent statement from the RACGP quoted the minister saying that she is not interested in ideology, but in what works. “We know that Aboriginal community controlled health initiatives consistently deliver positive health outcomes, and the RACGP has a long history of advocating for greater community involvement in developing health policy," read the RACGP statement. “We encourage the minister to work closely with the National Aboriginal Community Controlled Health Organisation, the Aboriginal Medical Services Alliance Northern Territory and Australian Indigenous Doctors Association in developing new policy approaches to deal with Australia 's most urgent health issue.” |
| Northern Territory intervention taskforce chair Sue Gordon has called for members of the Stolen Generation to receive private healthcare benefits for the rest of their lives to make the formal apology to be delivered by Kevin Rudd meaningful and not merely symbolic. In a report published in the Australian newspaper Ms Gordon said, "If the Commonwealth wants to assist with practical reconciliation, one good way is with medical assistance because most of the people are old now and on lots of medication and they should look at how they can spend the rest of their lives with free medical support. "They've said they are not going to give any compensation money so people should be looking for a practical way of bettering their lives and medical care is one." Barrister and Qld Indigenous leader Tammy Williams recently put a proposal to the Rudd and the Bligh governments for medical cover to apply to people who had their wages stolen. Ms Williams told the Australian that the scheme should also apply to the Stolen Generation. "If members of the Stolen Generation think it's something they would like I think it should apply to them as well. There are two ways it could be administered. One is completely private or it could operate like the veteran affairs scheme." |
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The CRCAH proudly co-sponsored ten Indigenous scholarships to Aboriginal and Torres Strait Islander people participating in the 1st Asia-Pacific Outgames, held in Melbourne recently.www.melbourneoutgames.org. The “Play with Your Neighbours” Outgames consisted of a human rights conference, 12 sporting tournaments, and a large cultural program. Embracing the gay and lesbian community and its friends in the Asia-Pacific region, the Outgames feature Indigenous queer and straight people in key events and all aspects of the Outgames. Some of the key Indigenous events included:
The scholarships are sponsored by Melbourne Outgames Incorporated, in conjunction with OutBlack, the ALSO Foundation www.also.org.au, and the Cooperative Research Centre for Aboriginal Health www.crcah.org.au Gregory Phillips, Executive Director, ABSTARR Consulting, is an Indigenous health expert and one of the Outgame's organisers. Passionate about human rights, sport and about culture, Gregory was keen to link excellence, style and passion in Aboriginal and public health with sport and the Outgames for good reason. He is a Waanyi and Jaru medical anthropologist, who has developed an accredited Indigenous health curriculum for all medical schools in Australia and New Zealand, and has published on addictions and post-traumatic stress syndromes in Indigenous communities. For further information contact: Gregory Phillips at gregory@abstarr.com |
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The Northern Territory 's Top End Division of General Practice has announced that the NT Administrator has created two new Administrator's Medals to honour those working in the primary health care sector in the Northern Territory . The two medals are:
You are invited to nominate any of the health care workers that provide primary health care to you including doctors, nurses, aboriginal health workers, allied health workers etc. Alternatively you can nominate your local health centre or local general practice as a team. Anyone can complete a nomination - a health care colleague, a consumer or another organisation. For more information and nomination forms: www.tedgp.asn.au Closing date for nominations is 7th MARCH 2008 |
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| A leading Aboriginal educationalist says Aboriginal education policy must work from an assumption that Indigenous Australians have the potential to develop the skills and capacity to address Indigenous problems. Chris Sarra, executive director of the Indigenous Education Leadership Institute, said the education revolution must be about capturing the hearts and minds of people, giving them a sense of hope and a way of thinking differently about Indigenous children; not about filling people's pockets with cash. Dr Sarra was responding to a proposal by Cape York Institute Director, Noel Pearson, offering a $50,000 tax-free bonus to attract experienced teachers to Indigenous communities. Welcoming a renewed focus on Indigenous education Dr Sarra said there was no doubt that the system “is in a parlous state at present.” “Noel Pearson's proposals are on the money when they articulate the need for quality teaching as a means to delivering improved educational outcomes in Indigenous communities,” said Dr Sarra. “Injecting high-calibre teachers is not in itself a bad strategy. “However any such proposals should follow on from strategies that promote high quality leadership in schools and are based on the embracing of local Indigenous community leadership. “We should totally reject any policy which is based on the assumption that white people need to ride to the rescue of the poor helpless Aborigine. “We must instead work from an assumption that Indigenous Australians have the potential to develop the skills and capacity to address Indigenous problems,” Dr Sarra said. Dr Sarra argued that the brightest and most high-powered teacher will achieve little or nothing if the local conditions at the school and the community are not prepared and adapted for that kind of intervention. “Leadership at the school and community level including principals, local leaders and Indigenous teacher aides is what makes a school succeed or fail.” Dr Sarra said that real educational change would occur by “changing the tide of low expectations of Indigenous children through the creation of Stronger Smarter Learning Communities across Australia .” “Our message about transforming Indigenous education has been clear and consistent. I say again, especially to my fellow educators: 'with the right mindsets and high expectations we can help create a stronger smarter reality for Indigenous children; a reality in which good education is the norm, in which community confidence can thrive and in which success is an achievable goal for every child across Australia'.” For more information on Dr Sarra's educational initiatives go to: http://www.strongersmarter.eq.edu.au/ |
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Tooth decay (dental caries) in young children is a major paediatric concern across Australia. For young Aboriginal & Torres Strait Islander children living in the NT, the levels of tooth decay are twice as high as those living in other parts of Australia and sadly not improving. Little children need teeth for eating, talking and smiling. Unfortunately, many NT children are getting sick and being sent to hospital because of serious teeth problems. Asking the question, 'In remote Indigenous communities of the Northern Territory, will a combination of oral health promotion and applications of concentrated fluoride varnish to young children's teeth (at least once every 6 months over a two year period) improve oral health?', the Strong Teeth for Little Kids project is a collaborative study between the Menzies School of Health Research (MSHR), the Australian Centre for Population Oral Health (ARCPOH at the University of Adelaide), and the Northern Territory Department of Health & Community Services (NT DHCS).
The project's aim is ‘trying to stop tooth decay and improve oral health in our little kids'. The project, an “in kind” CRCAH study funded by the NH&MRC, is a randomised controlled trial that is being conducted with the participation of 700 Aboriginal & Torres Strait Islander Children. The children are aged between 18 months and 4 years living in 30 remote Aboriginal Communities throughout the Northern Territory. The structure of the project is guided by ‘two masters' -the Chief Investigators and the Remote Communities Indigenous Reference Group. The Remote Communities Indigenous Reference Group, made up of 10 Indigenous members representing various communities and/or regions across the NT, is chaired by Warlpiri man Geoffrey Barnes who is based in Lajamanu. The group helps oversee the project, provides advice, and ensures cultural safety is maintained during the study. The research team visited more than 30 remote communities and consulted with key stakeholders prior to the study commencing. After receiving written confirmation and approval, the participating communities were randomised into the ‘Intervention' and the ‘Control' groups, and baseline oral examinations were conducted on all the children consenting to the study. Since completing the baseline survey, the intervention communities have been visited 3-6 monthly for:
This year is the final year of the study. All 700 children enrolled will have oral examinations conducted by Registered Dental Practitioners. Fluoride varnish will be applied to the teeth for the final time by the team. Oral health education will continue with health staff, store managers, crèches, child care centres & preschool. The Strong Teeth for Little Kids team thank all the remote communities, families, individuals and health boards involved in supporting this study. For further information please contact either Peter Morris or Iris Raye at Menzies on (08) 89228196.
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New research by a CRCAH PhD student has examined some of the obstacles to implementing Aboriginal health policy. Jane Lloyd recently completed her PhD at Sydney University after spending time working at CRCAH partner, the Menzies School of Health Research in Darwin where she managed a research project investigating the incidence and prevalence of diabetes and related conditions among Aboriginal people living in the Darwin region. She told Gwalwa-Gai that her initial plan was to conduct a randomised control trial of a diabetes intervention for Aboriginal people living in urban areas. However, she soon discovered that Aboriginal people are a diverse group of people and questioned whether one single intervention would be suitable for all Aboriginal people. “I was unsure whether designing another intervention was the best contribution that I could make,” she said. “Perhaps the greatest influence on my decision to focus on the health care system, rather than on Aboriginal people, stemmed from my experience as a white middle class Australian. “It seemed incredible to me, that at age 28, being brought up and educated in Australia, and having lived in Australia most of my life, I only had a very limited understanding of the history and needs of Aboriginal people. “If an educated member of mainstream Australian society stumbles by chance across the injustices faced by Aboriginal people, then it may also be possible that those systems that operate within a western framework such as health, education, and law can also be unaware of the needs of Aboriginal people. “By highlighting the health care system's contribution to persisting high rates of Aboriginal mortality and morbidity, it may be possible to identify how to re-engineer the system to better meet the needs of Aboriginal people,” she told Gwalwa-Gai. The implications of Jane's research are relevant at two levels. The research has shown that when implementing policy it is important to discern who needs to be involved in the policy decision-making process and at what point; to identify the deal breakers in negotiations about which aspects of policy are implemented; to find ways to build the capacity of health services during implementation; and to monitor the evolution of policy ideas. In addition, the research found the implementation of policy depends upon there being a robust underlying health care system. In a region such as the Northern Territory , it is common to find health services that are inadequate to meet the demands of the communities they serve. Developing and implementing stand alone policies in the absence of a comprehensive health care system will not improve Aboriginal health. Jane says the support she received from the CRCAH went far beyond her scholarship funds, “The CRC provided extraordinary opportunities to share ideas and stay in touch with Aboriginal health issues. In particular, collaboration with one of the CRC projects – ABCD – provided fertile ground for learning about chronic disease management in Aboriginal health services and for networking with those working in a similar area.” Jane has now joined the Centre for Clinical Governance Research at the University of NSW as a Postdoctoral Research Fellow. She will continue to examine ways the health care system can build capacity to better meet the needs of the populations they are intended to serve. To read Jane's PhD thesis: Click here [pdf] |
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| Research points to cannabis cancer 'epidemic' | ||||||
New Zealand researchers have warned that smoking a cannabis joint is equivalent to 20 cigarettes in terms of lung cancer risk and have warned of an "epidemic" of lung cancers linked to cannabis. Researchers at the Medical Research Institute of New Zealand reported their findings on the cancer risk of pot smoking in the European Respiratory Journal. Studies in the past have reported smoking cannabis can cause lung cancer, but few have quantified that relationship, says Dr Richard Beasley, Institute Director, and a key problem has been separating out the contribution of tobacco, which is often mixed with cannabis. Beasley and team interviewed 79 lung cancer patients and sought to identify the main risk factors for the disease, such as smoking, family history and occupation. The patients were questioned about alcohol and cannabis consumption. The researchers found those who smoked more than a joint a day for 10 years, or two joints a day for 5 years were more than 5 times more likely to have lung cancer than those who didn't smoke at all - after adjusting for other variables, including cigarette smoking. "While our study covers a relatively small group, it shows clearly that long-term cannabis smoking increases lung cancer risk," says Beasley. Beasley says cannabis could be expected to harm the airways more than tobacco as its smoke contains twice the level of carcinogens, such as polyaromatic hydrocarbons, compared with tobacco cigarettes. Smoking cannabis also increases the risk, since joints are typically smoked without a proper filter and almost to the very tip, which increases the amount of smoke inhaled, he says. He says the cannabis smoker inhales more deeply and for longer, facilitating the deposition of carcinogens in the airways. "Cannabis smokers end up with five times more carbon monoxide in their bloodstream (than tobacco smokers)," he says. "What is intriguing to us is there is so little work done on cannabis when there is so much done on tobacco." |
The Centre for Excellence in Indigenous Tobacco Control (CEITC) at the University of Melbourne is seeking to appoint a Research Fellow (level B). The successful applicant will take a lead role in providing advice on strategic research directions and a research plan to the national Indigenous tobacco control research network and working group. Undertaking independent research activities and taking a lead role in the implementation of the CEITC research plan is required. They will also be involved in research training and supervise postgraduate students in relevant areas. A full position description is available at http://jobs.unimelb.edu.au/jobDetails.asp?sJobIDs=408842 . |
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The Quality Improvement Program Planning System (QIPPS) located at www.qipps.com is a not-for-profit system of tools, support and clearinghouses designed by a community health service and managed by the Victorian Community Health Association. The office is located within the Australian Institute for Primary Care at La Trobe University. About 120 organisations in Australia and New Zealand currently access the QIPPS system. QIPPS actively assists organisations with the planning and evaluation of quality health promotion and community development projects using the following:
Several QIPPS workforce development sessions are planned for 2008 in Australia and New Zealand. Contact qipps@qipps.com for more information. |
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As foreshadowed in the previous issue of Gwala-Gai, a special December 2007 edition of Health and History focused on Indigenous health has just been published after two years' hard work by the Onemda VicHealth Koori Health Unit. Onemda head and CRCAH Research Director, Professor Ian Anderson, who jointly edited the special issue with former Onemda staffer Kim Humphery, said in the introductory editorial that while Aboriginal and colonial history was “a vibrant, dynamic area of research”, the “development of a historical focus on Aboriginal health is relatively patchy”. The essays included cover three principal themes: the Aboriginal experience of health and health services over time; the colonial and 20th century construction of medical knowledge in relation to Aboriginal health; and the recent history of Aboriginal health organisations. Included in the issue are seven feature articles, two exhibition reviews, five book reviews and a research note on the history of ear disease in Aboriginal children. The articles cover such topics as the history of the dormitory system at Balgo Mission in WA (Brian McCoy), the link between health intervention and policing in the Queensland Aboriginal community of Cherbourg (Leonie Cox), and white constructions of Aboriginal mental illness from the 1880s onwards (Caitlin Murray). Also included is Warwick Anderson's important discussion of the historiography of Indigenous health. Health and History is the journal of the Australian and New Zealand Society of the History of Medicine. The special edition (vol. 9, no. 2) is available from www.historycooperative.org/hahindex.html. |
The Australian Indigenous HealthInfoNet has developed a new ‘one-stop info-shop' for people working, studying or interested in addressing issues that influence the social and emotional wellbeing of Indigenous peoples. The new web pages aim to provide quality information and resources about how to promote the social and emotional wellbeing of Indigenous peoples. The new pages are in two parts:
Gwalwa-Gai readers are invited to join the yarning place at no cost and start the valuable process of knowledge and experiences sharing with others working in this area. www.healthinfonet.ecu.edu.au/sewb
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| Special Indigenous health edition of rural health journal | |||||||||
The Australian Journal of Rural Health has just published a “virtual issue” on Indigenous health intended to be a one stop shop for the Journal's published research in area of Indigenous health. The edition features a reprint of an address given by CRCAH patron and Aboriginal Elder Statesperson, Dr Lowitja O'Donoghue, “Towards a culture of improving Indigenous health in Australia . The edition also includes articles on diabetes management, women's health and birthing, mental health, substance abuse and challenges to health service managers. To read this virtual issue go to: http://www.blackwell-synergy.com/toc/ajr/16/v1
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| Cancer Council develops new cervical cancer resources – an interview with Peta Reynolds | |||||||||
Aboriginal women are five times more likely to die from cervical cancer than non-Aboriginal women. These figures demonstrate an enormous need for improved health promotion campaigns to help raise awareness about this cancer and how to prevent it through regular Well Women's Checks (Pap tests).
One organisation that is meeting this challenge is PapScreen, a program within the Cancer Council Victoria, which has developed several informative, useful and culturally appropriate resources for Aboriginal and Torres Strait Islander health organisations, health workers and women. Driving the development of these resources is Peta Reynolds, an Aboriginal woman from the Walbanja tribe, which is part of the Yuin nation of the NSW south coast, who recently spoke to Gwalwa-Gai about her work…….. What is your role at PapScreen Victoria? As the Aboriginal Education Program Coordinator at PapScreen I focus on developing, implementing and evaluating cervical cancer prevention initiatives targeting Aboriginal women in the community. This involves promoting the importance of two yearly Well Women's Checks (Pap tests) and the availability of the new cervical cancer vaccine. I also support several other programs at the Cancer Council Victoria, including Breast Health, Men's Health, Bowel Screening and Obesity Prevention. This involves making sure these cancer prevention programs are targeting Aboriginal communities effectively and promoting these services and programs within the Victorian Aboriginal community. What involvement did you have in putting together the most recent brochures/posters on cervical cancer screening? For the Growing Strong resources, I drafted the text, undertook extensive community consultation, and sourced the local Victorian artist Kahli Luttrell, a Yorta Yorta woman. For the Protecting Our Mob brochure and poster resources, the same process was undertaken and a local Victorian artist Paola Morabito, a Wemba Wemba and Gunditjmara woman, was sourced to provide the artwork. In your consultations with the Indigenous communities, how important was their feedback for the messages in the brochures and the posters? I think it's important to involve the community, especially Aboriginal health workers, in the development of health-related resources. This provides a level of ownership, which results in health workers using and distributing the resources more effectively. It's also done to make sure the messages are developed right the first time. Community consultation is vital to developing culturally appropriate resources, and should occur at all stages, in planning, implementation and evaluation. Consultations are face-to-face with individuals and with groups. Partnerships have to be established with all key stakeholders, including Aboriginal Community Controlled Health Organisations, Aboriginal Health Services and the community, to ensure these important health messages are getting out there. Where are the posters and brochures going? Brochures and posters are sent to Victorian Aboriginal health services and Aboriginal health workers, free of charge. Other states can also order these resources, free of charge, from the PapScreen website at www.papscreen.org.au. There is also a lot of useful information on the Cancer Council Victoria's website at http://www.cancervic.org.au/preventing-cancer/aboriginal-health. Contact: Peta Reynolds, at PapScreen Victoria , on 03 9635 5316 or email peta.reynolds@cancervic.org.au for further information.
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| Cancer Council calls for entries in Indigenous art award | |||||||||
Indigenous Australian artists of all ages and ability are being encouraged to use their skills in artistry and story telling in this year's Cancer Council Victoria Arts Awards. The Cancer Council is calling for entries in the Indigenous Visual Art category of the Arts Awards, an annual event that provides an opportunity for people to express their cancer experiences artistically. Works can include painting, photographs, craft or sculpture and can represent someone's own experience with cancer, or that of a loved one. The Outstanding entrant for the Indigenous Visual Art category will receive $1,000 cash, and selected artworks will be displayed in an exhibition which tours Melbourne and regional Victoria. “Cancer can be difficult to talk about in the community, and this a ward gives people an opportunity to express their personal stories in a way that makes them feel comfortable,” said the Cancer Council's Aboriginal Education Program Coordinator Peta Reynolds. “These awards bring together people who have been touched by cancer, while also raising awareness of the support services and resources available at the Cancer Council,” said Ms Reynolds. “Cancer is a major health issue for all Australians, especially in Indigenous communities, so raising awareness about accessing information about how to prevent and detect cancer is vital,” added Ms Reynolds. Bronwyn Razem, a respected artist from the Victorian Indigenous community, will judge the Indigenous Visual Art Award in 2008. Last year's winner was Mandi Barton with her painting Swallowed. Entries are now open, with a closing date of Friday 4 April 2008. For an entry form and more information call 1300 65 65 85, visit www.cancervic.org.au/artsawards or email arts.awards@cancervic.org.au . Or you can contact Angela Nagel – Arts Awards Officer on 03 9635 5157 angela.nagel@cancervic.org.au or Clare Price – Media and Communications, PapScreen Victoria, on 9635 5427. View Flier
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The National Indigenous Drug and Alcohol Committee (NIDAC) is running a national competition to create a new logo with a prize of $5,000 for the winning entry. Creators of the three favourite entries will receive a trip to the National Drug and Alcohol Awards in June where the winner will be announced. Artists and others are urged to submit a logo that is identifiable amongst Indigenous Australians and depicts the National Indigenous Drug and Alcohol Committee (NIDAC) as “the leading voice in Indigenous Drug and Alcohol Policy”. The competition closes 21 st March 2008. For more information: Click Here [pdf] Or contact Sue-Anne Morley, Executive Officer NIDAC: 02 6166 9604 or 0437 001 247
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| TV news service presents new opportunities for dissemination | |||||||||
National Indigenous Television (NITV) has launched it news service with daily five minute bulletins, five days a week. “This new service should be well utilised by Aboriginal health researchers and organisations like the CRCAH to ensure Aboriginal people are made directly aware of the latest developments in health research,” said Alastair Harris. “I have no doubt that the CRC will take up the new research dissemination opportunities provided by the news service.” For more information: http://nitv.org.au/get-nitv/foxtel/ |
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Charles Darwin University 's Graduate School of Health Practice (GSHP) is reinforcing its growing reputation in Aboriginal health education and research with the roll-out of new courses to address critical shortfalls of health practitioners, particularly in remote areas. Key to the new courses is an emphasis on Aboriginal participation in all areas, from membership of the Course Advisory Group, curriculum development, unit content and teaching through to the encouragement of Aboriginal student enrolments. The shortfall of midwives throughout the Northern Territory currently reaches into the hundreds and is a priority area for NT health authorities. GSHP, with Commonwealth funding, is developing a Bachelor of Midwifery program specifically designed for Aboriginal students. The 'Indigenous Pathways to Midwifery' project creates direct entry pathways to enable Indigenous people to enrol in higher education without the ‘normal' entry requirements. Specifically, Indigenous students will be able to participate in a six-month preparation program as a precursor to undertaking the formal Bachelor of Midwifery. The program will use innovative educational techniques including work-based learning in a variety of clinical and community settings, and will enable graduates to register as midwives in the NT. GSHP will also develop a Bachelor of Midwifery curriculum, the first in the NT. A further development is a proposed Nurse Practitioner (NP) course to commence in 2009. The NP role has been given a high priority by the NT Department of Health and Community Services as one way to address the gaps in health service delivery in areas such as emergency, mental health and remote communities. The NP course will provide nurses and midwives with the advanced and extended practice knowledge and skills they need to take on non-traditional activities such as advanced patient assessment, prescribing, ordering laboratory and radiology tests, or making and accepting referrals. Both these new courses will draw on the success of existing courses such as the Graduate Diploma in Child and Family Health, which has attracted enrolments from across Australia . The course offers pathways for Aboriginal health workers to upgrade their knowledge and skills in child health, parent education, and family support in a wide range of settings including remote communities. The GSHP is also very busy on the research front. Several of its large research grants have already been developed and implemented with Aboriginal communities, health boards and researchers, for example:
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La Trobe University builds health research networks with local Indigenous groups |
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Now in its second year, the summer clerkships of the La Trobe University's School of Public Health program is supporting the work of the Cooperative Research Centre for Aboriginal Health (CRCAH) in the north and west metropolitan region of Melbourne where the university is located. Following the success of the summer clerkships last year, the School of Public Health has recently placed two of its undergraduate students, Alice Wilkin and Verity Nicholson, in to an Indigenous networking project. Over eight weeks this summer, Alice and Verity are investigating local community organisations for their links to CRCAH's program areas. The intention is to expand the school's research networks with community groups locally, state-wide and nationally in several key health areas. As a link person between the school, the CRCAH and the Indigenous community, Penny Smith, a research officer at the school, organised the part-time placements. “I encouraged my placement students, Alice and Verity, to apply for the clerkships. We were successful in our applications to the school, so we submitted a full updated plan. Alice and Verity began work on this clerkship in early December and they've had some early successes,” said Penny. Alice and Verity are looking at activities of Indigenous groups in the North and West metropolitan region of Melbourne that focus on improving Indigenous health and supporting Indigenous communities. The two students are classifying the activities of these groups using the five program areas of the CRCAH – Healthy Skin, Social Determinants of Health, Chronic Disease, Social and Emotional Wellbeing, Comprehensive Primary Health Care, Health Systems, and Workforce. At the end of the eight weeks, they hope to achieve the following outputs:
The two students are collecting lots of data through face-to-face meetings with existing community groups and agencies, rather than just e-mail, phone contact, and teleconferencing. “We're meeting and working with community health organisations, such as the Victorian Aboriginal Community Controlled Health Organisation, Victorian Aboriginal Child Care Agency, and the Victorian Aboriginal Health Service. We are also talking with local government people who have a good understanding and involvement with Indigenous people and organisations and their programs,” said Alice . In addition to consultation, they are undertaking their investigations through Internet-based research and web data collection. The two students have been pleasantly surprised by the large number of high-quality activities and events being carried out by, or involving, Indigenous groups in the north and west of Melbourne . “It's a lot bigger than we initially thought, there are so many significant activities and events at national, state, and local levels, both big and small, that the general community and researchers should know about, and they range from the very large national events such as NAIDOC Week through to small local events such as choir nights for Aboriginal elders,” said Alice. “We are using the snowball method to contact people, where people refer you to other people, and it's really become a big snowball!” Alice added. “At the moment, we've got lots of paper covering programs and events, that need to be entered onto our website.” Penny, Alice and Verity see their practical work as eventually opening up research opportunities for the university in concert with community groups and in strengthening the networks and linkages between researchers and community groups, and the CRCAH. For further information contact: Penelope.smith@latrobe.edu.au |
