Australia

Indigenous children at Ghumarn Cultural Centre, NT. Photo: Claude Ho.

Professor Fred Hollows worked tirelessly to tackle the crippling health conditions and inequities experienced by Indigenous Australians.

Overview

Fred Hollows was committed to improving Indigenous health. Photo: Stephen Ellison Fred took eye care to some of Australia's most remote Indigenous communities—he was active in the establishment of Australia’s first Aboriginal community controlled medical service at Redfern in NSW, and he spoke out about the shameful state of Indigenous health compared to the health of all other Australians.

With Fred as our inspiration, The Foundation’s work in remote Australia includes work to improve Indigenous eye health, but goes beyond eye care—we are contributing to improvements in Indigenous health by working with Aboriginal community-controlled health services in the Northern Territory, Queensland, New South Wales, Western Australia and South Australia.

The Indigenous Australia Program (IAP) has a renewed focus on two key health areas:

Primary health care delivered through Aboriginal community-controlled health services
Building integrated eye health systems for Indigenous Australians

Our work in these areas reflect The Foundation’s vision and objectives in eliminating avoidable blindness and making a meaningful contribution to improving Indigenous health in the communities where we work. A specific focus on primary health care and Aboriginal community-controlled health services is based on evidence that primary health care can make a significant contribution to improvements in health and reflects The Foundation's longstanding commitment to working directly with Indigenous communities—in this case through organisations controlled by community members.

Indigenous health

The IAP is working in partnership with Aboriginal community-controlled health organisations and the peak bodies that represent them. To ensure that our efforts are directed towards health issues and activities that are important and will impact on the health of Indigenous people, the IAP is directed by priorities agreed with the peak organisation. So far, priorities have been set with the Aboriginal Medical Services Alliance of the Northern Territory (AMSANT) to guide our programs in the Northern Territory, where most of the IAP’s programs operate. The agreed priorities are:

Eyes
Male health
Governance
Health workforce
Nutrition

Ending avoidable blindness

Lesley Stafford after his eye operation at Alice Springs Hospital. Photo: Hugh Rutherford Right now, Indigenous Australians suffer six times the rate of avoidable blindness and vision loss of other Australians. They have lower access to eye health services and are more likely to experience risk factors for poor eye health, such as Type 2 Diabetes.

In the Australian setting, ending avoidable blindness involves working to improve the capacity of an established health system to provide accessible, equitable, effective and appropriate eye health care to Indigenous Australians.

To do this, we are investing our efforts into achieving comprehensive integrated eye health systems and programming appropriate for Indigenous Australians.

Comprehensive eye health systems cover the spectrum from primary through to tertiary services, and includes education and prevention, screening, refractive error, medical and surgical eye systems and services.

Achievements 2011

Working together with government agencies and local partners, The Foundation has:

Eye health

Increased eye surgery rates for Indigenous people from the remote Central Australia and Barkly region by improving surgery scheduling and patient transport links with Alice Springs Hospital
Screened 416 people in remote Northern Territory communities, provided optometry services and dispensed 1,014 pairs of affordable spectacles
Funded an eye nurse who co-ordinated 189 ophthalmology and optometry consultations for people living in the remote Anangu Pitjantjatjara Yankunytjatjara (APY) Lands of South Australia
Funded an orthoptist to provide eye health services to Indigenous people living in far west NSW
Trained 45 community health workers to diagnose eye disorders using a slit lamp donated by The Foundation
Delivered five non-mydriatic cameras to remote eye clinics in the Northern Territory for early detection of diabetic retinopathy
Educated 75 children in the Northern Territory on facial cleanliness – essential to eliminate the blinding infectious disease trachoma.

Essential health care

Funded doctors and nurses to provide health checks for 346 adults and 96 children from South Australia’s APY Lands to prevent, detect and treat diseases like diabetes
These doctors and nurses also performed growth checks on 493 Indigenous children in the APY Lands. Thirty-one toddlers with nutrition-related problems are now on growth action plans to improve their health.

Leadership

Supported the Close the Gap coalition – bringing public attention to the health issues facing Indigenous Australians
Provided training to 86 Indigenous people, including health professionals, so they can better speak out on their rights and lead in their communities
Raised the profile of important policy issues affecting Aboriginal people by supporting Indigenous organisations to form an alliance. This alliance, the Aboriginal Peak Organisations NT is now regularly consulted by the Federal and Territory governments.

Young people

Helped a youth drop-in centre in far west NSW to build Indigenous teenagers’ life skills and self-esteem. Up to 90 young people attended each day
Supported school holiday programs for Indigenous students to learn about bush tucker, bush medicine and culture from their elders.

Nutrition

Provided 230 Aboriginal infants and small children in remote Northern Territory, West Australian and Queensland communities with a nutritional supplement to combat iron deficiency
Trained 10 community health workers to run a peer support program for mothers on healthy feeding for babies. One hundred mothers attended
Trained seven Indigenous community health workers to improve nutrition and bring healthy food into their communities.

Women's development

The women of the Northern Territory’s Jawoyn region now have a strong voice in decisions across the region through the election of Banatjarl Women’s Council – a product of long-term support for women’s development provided by The Foundation
Women from the Jawoyn region shared their experiences with the United Nations High Commissioner for Human Rights, Navanethem Pillay
Jawoyn women came together from over 10 remote communities to discuss how traditional law can work alongside the modern legal system
Supported the development of Mibala Wei – Art and Craft our way, a book by the female artisans of Gulin Gulin near Katherine. Over 500 copies are now being used by women’s centres and art centres in the Northern Territory to develop their own art and craft enterprises.

About the program

The Foundation supports training in healthy food preparation at Manyallaluk Community, NT. Photo: Sasha Woolley The Foundation’s vision of 'a world in which no person is needlessly blind and Indigenous Australians exercise their right to good health' is achieved by the IAP through partnerships with Aboriginal Community Controlled Health Services (ACCHSs) and their peak organisations, along with the Commonwealth and Northern Territory governments.

We support:

The Central Australia and Barkley Integrated Eye Health program, the Greater Darwin Integrated Eye Health Program, and the Katherine Integrated Eye Health Program.
Sunrise Health Service aural health program, tackling chronic middle ear infection (which affects almost half of the young children in some communities in the East Katherine region).
Delivery of comprehensive primary health care on the APY Lands in remote South Australia: Closing the Gap through enhancing the capacity of Nganampa Health.
The Aboriginal Medical Services Alliance of the Northern Territory (AMSANT) and Aboriginal Community Controlled Health Services in the vital areas of governance, policy capacity, advocacy and health service leadership.
The prevention of anaemia in young children, trialling ‘Sprinkles’, a micronutrient supplement, and providing education to new mums about feeding babies and infants.
Training in human rights, supporting the Diplomacy Training Program and Indigenous human rights networks in Australia.
Male health; we’re partnering with Wurli Wurlijang to improve male health with the ‘Strongbala’ program.
Nutrition and food security; including the development and implementation of a certificate level short course for Indigenous Australians and across Asia Pacific, an action research project based in remote community stores to test and develop nutrition promotion approaches and resources relevant to local communities, and the Banatjarl Women’s Council to improve nutrition in their region east of Katherine.
Youth programs; we’re working with Maari Ma Health to achieve sustainable funding for the WINGS drop in centre, catering for school age children in Wilcannia NSW.

Facts and figures

More than a third of Indigenous homes in the Northern Territory (NT) are over-crowded, putting people at greater risk of infectious diseases and other physical and mental health problems. Recent studies show:


Eye health	In the Northern Territory, nearly 20% of Indigenous children under 10 have active and infectious trachoma, an eye disease that causes blindness if left untreated, and 32% of Indigenous people over 20 have corneal scarring.
Aural health	Up to 40% of young children in Indigenous communities living in remote parts of Australia are affected by chronic suppurative otitis media (CSOM), a serious middle ear infection that causes permanent hearing loss. The World Health Organization considers Australian Indigenous people to be a 'special high risk group' for CSOM.
Life expectancy	approx. 10 years less than for other Australians (lowest in the Northern Territory with 61.5 years for men and 69.2 years for women). Indigenous Australians aged 35 to 54 are 23 to 37 times more likely to die from type 2 diabetes than other Australians in that age group.
Infant mortality rate	13.6 per 1000 in infants less than one year of age in the Northern Territory, twice the rate of non-Indigenous infants
Nutrition	13% of Aboriginal children 0-5 years in remote NT are underweight and 31% of 6-12 months were anaemic, according to the ‘NT Healthy under-Five Kids’ program (2009).
Literacy rate	only a third of Indigenous children living in very remote communities can read at the accepted minimum standard.

Sources:

Experimental Life Tables for Aboriginal and Torres Strait Islander Australians, 2005-2007, 3302.0.55.003, Australian Bureau of Statistics, May, 2009

The Health and Welfare of Australia's Aboriginal and Torres Strait Islander Peoples (cat no. 4704.0), Australian Institute of Health and Welfare, 2008

Making Progress: The health, development and wellbeing of Australia's children and young people. Australian Institute of Health and Welfare, 2008

Guidelines for the public health management of trachoma in Australia,Australian Government Department of Health and Ageing, 2006

Chronic suppurative otitis media: Burden of illness and management options, World Health Organization (2004) p.18

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Aboriginal communities