National Reconciliation Week 2021
‘We’ve been successful because we’ve had a seat at the table, where we’ve had respect for our knowledge and community connection, and it’s been a true partnership, not just a brown face at the table.’ – Dr Lorraine Anderson, Kimberley Aboriginal Medical Services
Our Reconciliation journey
The Public Health Association of Australia (PHAA) holds a deep commitment to the physical and mental health and wellbeing of all Australians. We care about equity and leaving no-one behind, about justice and human rights. With these principles guiding our organisation every day, it follows that Reconciliation between Aboriginal and Torres Strait Islander people and non-Indigenous Australians is a major priority.
The PHAA recognises First Nations people as the Traditional Owners of this land, and strongly supports the Reconciliation Week theme for 2021: More than a word. Reconciliation takes action.
The PHAA recognises that Reconciliation is a journey for all Australians. At the beginning of this Reconciliation Week, we pledge our commitment to contribute to national efforts to acknowledge Aboriginal and Torres Strait Islander cultures, histories, languages, knowledges and practices as foundational to our national story.
Together, we are a community of people who can craft solutions, help bring current harms to an end, reconcile the historical and continuing impacts left to us, and leave a healthier world to those who come after us. This is public health in action and it is Reconciliation in action.
Reconciliation at work in a health emergency
At the PHAA’s recent Preventive Health Conference in Perth, the closing plenary highlighted some of the genuine success stories, and how the entire public health community has responded, to the COVID-19 pandemic. The session demonstrated the spirit of Reconciliation at work in the context of saving lives and keeping many of the most vulnerable Australians safe. We thank our three presenters: Dr Dawn Casey, Deputy CEO of the National Aboriginal Controlled Community Health Organisation (NACCHO), Dr Lorraine Anderson, Medical Director at Kimberley Aboriginal Medical Services, and Ronda Clarke, Mappa Project Manager at the Aboriginal Health Council of Western Australia.
A national/international success story
Dr Casey highlighted the incredible success to date in keeping COVID out of vulnerable remote Aboriginal and Torres Strait Islander communities.
‘I give thanks every day that to date only 150 Aboriginal and Torres Strait Islander people have contracted COVID, and thankfully there have been no deaths,’ Dr Casey said. ‘In Australia, infection rates amongst Aboriginal and Torres Strait Islander people are six times less than in the wider Australian community.
‘By contrast though, as reported in the Washington Post, COVID-19 has killed native Americans at a faster rate than any other group in the United States.
‘We are conscious, however, that our job isn’t done until we have all our people vaccinated. Only then will we breathe a lot easier,’ Dr Casey said.
The reasons behind the success in keeping Aboriginal and Torres Strait Islander people safe from COVID are multi-faceted. Dr Casey listed the early closure of borders and an effective communications campaign developed by health services working closely with communities as playing a critical role in preventing the spread.
‘We have a network of 141 Aboriginal, community-controlled health services located in remote, regional and urban areas, which collectively have between them 450 clinics. Each service is controlled by the community receiving the service, and each was integral in designing and leading the response, to protect our communities throughout Australia,’ Dr Casey said.
Support from government
Dr Casey also praised the actions of the Australian Government for its swift response in the early days of the pandemic reaching Australia.
‘The willingness of the Australian Government to pursue the closure of our borders early last year, following a request from our communities was a courageous and necessary action,’ Dr Casey said.
‘The Australian Government established an Indigenous Advisory Committee which included Aboriginal doctors, CEOs from community health services, NACCHO affiliates, public health medical officers, Aboriginal communicable disease experts, state and territory government health officials and clinicians.’ This Committee is still operating effectively today.
‘For Aboriginal and Torres Strait Islander people we’ve always understood that our health is broader than just physical health. Our health and wellbeing are intrinsically knitted to the land, language, culture and each other, and in particular looking after our elders. If we protect our elders and our children through prevention, we protect our culture and our people for generations to come. It is how we’ve survived to date and how we will survive in the future,’ Dr Casey said.
The Kimberley COVID experience
The Preventive Health Conference also heard first-hand from Dr Lorraine Anderson, from the Kimberley Aboriginal Medical Services of the experiences from one remote community. She said their pandemic action plan swung into action even before the first case was diagnosed in Australia.
‘In the Kimberley, our response started in January 2020 when we first heard what was happening in China,’ Dr Anderson said. ‘We quickly started putting together PPE and boxes of pandemic supplies to go out to communities.
‘We also knew to get the messages out effectively we needed to be very community focused and at the same time we needed to respond rapidly. In March 2020, actions by the WA Government in declaring a State of Public Health Emergency provided us with additional controls and measures to effectively respond to COVID. Those measures included a Kimberley biosecurity border, and also travel restrictions, quarantine and self-isolation orders, and restrictions on public gatherings.’
March 2020 also saw the creation of a Kimberley COVID interagency team which met daily to oversee the response and share information. Dr Anderson said this team was fundamental to the success of the response and she hopes it will remain in place beyond the pandemic.
‘Through shared decision-making, good governance, community control, and ensuring that Aboriginal and Torres Strait Islander community-controlled organisations and state affiliates had representatives and input into all aspects of the COVID-19 planning and response was another important factor in managing the pandemic effectively.
‘We’ve been successful because we’ve had a seat at the table, where we’ve had respect for our knowledge and community connection, and it’s been a true partnership, not just a brown face at the table,’ Dr Anderson added.
Telehealth for remote communities
The Kimberley was also an early adopter of Telehealth.
‘Within weeks we had our doctors in Broome able to do Telehealth consultations with their patients out in communities, and this played a big role in our ability to maintain our primary care services, and in particular in those very remote communities,’ Dr Anderson said. ‘We didn’t want our staff going in and out constantly and we wanted to limit that as much as possible to limit the risk of COVID-19 getting in. So, we reduced the number of providers moving into and out of the community but maintained the support, and developed some really robust processes for Telehealth, which will continue to be used in the future, beyond COVID.’
Dr Anderson said the highest risk was the possibility of just one single COVID case getting into a remote Aboriginal community. ‘We suspected if there was one positive case in one of these communities there would be 70 other people sitting behind that one case that were also positive, that we hadn’t picked up yet.’
The introduction of seven Point of Care testing sites during the pandemic meant patients who otherwise might be airlifted, or taken by road to Broome for their isolation while awaiting their test results, could remain in their communities.
‘This was a logistical nightmare and took up a lot of resources and caused a lot of concern for community members, not to mention a reluctance for people with symptoms to present. We estimated in the first seven months of the pandemic, through Point of Care testing we prevented 125 air evacuations, which cost about $10,000 each, and 144 road evacuations.’
Dr Anderson said the focus now was on rolling out the vaccination program and continuing to educate the community about how to deal with COVID.
‘Communication is the most important aspect of the response, across agencies and into communities, with a lot of localised messaging and graphics in language which can be rolled out quickly.’ she added.
The Mappa phenomenon
The forum concluded with an astonishing presentation of a free-to-use online technology, Mappa, which at the click of a button can provide every possible detail about every health service currently available across the vast state of Western Australia, including within some of the smallest, most isolated communities in the world.
Its creator, Ronda Clarke, said the idea behind Mappa was to provide a one-stop-shop, to give people all the information they needed ‘to get the right care, in the right place, at the right time.’
The Mappa platform contains key dates, times, locations, health and cultural information, and contact details for traveling and permanent health services. It provides culturally appropriate, up-to-date and reliable information for health services, health professionals, clients, GPs, patients, hospitals and any other services linked to health care across the whole of WA.
‘If COVID has taught us anything it’s about genuine meaningful partnerships, and this tool is not only for Aboriginal people. This tool is for everybody,’ Ms Clarke said.
The Mappa online model has been so successful it will soon begin being rolled out across Australia, starting with SA and the NT, and there’s also been considerable interest internationally from Norway, the UK, Canada, Japan and Singapore.
The COVID-19 pandemic has created chaos, confusion and fear across the nation. But it has also demonstrated how a true collaboration involving Aboriginal and Torres Strait Islander people in prominent roles can deliver positive results that every Australian should be proud of.