Australia

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

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 took eye care to some of Aust Stephen Ellisonralia'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

 Hugh RutherfordRight 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 2013

Eye Health 

Delivering services
  • Increased eye surgery rates and decreased waiting times for Indigenous Australians in the Northern Territory, South Australia and New South Wales by improving patient pathways to services
  • Supported 282 cataract surgeries and 34 other sight-saving interventions at intensive surgery weeks in Alice Springs and the Top End
  • Screened 1,044 people in remote communities, providing optometry and ophthalmology services and affordable spectacles to those in need.
Investing in people
  • Supported the employment and training of 12 Aboriginal community based workers to join the Trachoma Elimination Program in remote communities across the Northern Territory – increasing participation in trachoma screening and treatment and boosting uptake of face washing amongst children
  • Trained one doctor, two nurses and two Aboriginal health practitioners to perform sight-saving laser treatment on diabetic retinopathy patients in the Top End
  • Funded two eye health co-ordinators to provide logistical support to outreach optometrists in the Top End
  • Funded an orthoptist to provide eye health services to Indigenous people living in far west NSW
  • Trained 62 primary health care workers from 10 community clinics to detect eye disease and refer patients for further treatment.
Research and innovation
  • Partnered in a project that uses telehealth to manage diabetic retinopathy, diabetes and cardiovascular disease
  • Connected three remote Indigenous health organisations with a retinal grading centre, reducing the time taken to assess retinal images to just 48 hours
  • Funded a new software program to assist health professionals in Alice Springs, Katherine and East Arnhem Land with the management of chronic disease
  • Delivered three retinal cameras to health clinics to increase diabetic retinopathy detection
  • Produced a short film starring Indigenous puppets to educate people about having regular eye checks. Over 900 copies of the DVD Looking Good have been distributed to remote communities.

General health

  • Funded a study which documented alarming rates of anaemia amongst youngsters living in remote areas of northern Australia and highlighted the need for urgent action to improve nutrition for mothers, babies and young children
  • Continued to fund a doctor and three nurses to provide comprehensive health checks for adults and children from South Australia’s Anangu Pitjantjatjara Yankunytjatjara (APY) Lands to tackle chronic disease
  • These doctors and nurses also performed growth checks on all 127 Anangu children under three years old. In addition, all 174 Anangu children aged between six months and six years were fully immunised
  • Funded a resource package for remote health workers aimed at improving nutrition in remote Indigenous communities.

Empowering Leaders

  • Provided training to 82 Indigenous Australians, including health professionals, supporting them to better speak out about their rights. Over the past five years participants in the Diplomacy Training Program have gone on to lead their communities in areas including running for public office, lobbying for changes to intervention laws and joining local boards
  • Along with other Vision 2020 members, we developed and endorsed principles for a national low cost spectacle scheme to address high rates of uncorrected refractive error experienced by Indigenous Australians
  • Supported the development of a set of principles by Aboriginal Peak Organisations Northern Territory to help NGOs work effectively with Indigenous communities. These have now been adopted by local, national and international NGOs.

We acheived these results working together with government agencies and local partners. 

About the program

 Sasha WoolleyThe 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

What we can do

Help keep Fred’s dream alive.

4 out of 5 people who are blind in the developing world don't need to be. Routine treatment costing as little as $25 can restore sight and hope.