13 Annual Report - Anyinginyi Health Aboriginal Corporation
Transcription
13 Annual Report - Anyinginyi Health Aboriginal Corporation
ANYINGINYI HEALTH ABORIGINAL CORPORATION 2012/2013 ANNUAL REPORT Ngarunyurr Parlpuru Munjarlki ‘PREVENTION IS THE SOLUTION’ Table of Contents INTRODUCTION 2 GOVERNANCE STRUCTURE 5 CHAIRPERSON’S REPORT 6 BOARD OF DIRECTORS 8 GENERAL MANAGER’S REPORT 14 DIRECTOR OF CLINICAL SERVICES REPORT 15 2012/2013 ANYINGINYI UPDATES 18 The Foetal Alcohol Spectrum Disorder Project Bush Tucker & Medicine Education 18 20 2012/2013 ANYINGINYI HIGHLIGHTS NAIDOC Week Celebrations Staff Achievements The Tackling Smoking Program Trachoma Elimination Program 22 22 24 25 26 PRIMARY HEALTH CARE SERVICE DELIVERY MODEL 28 2012/2013 SECTION REPORTS Nyangirru Piliyi-ngara Kurantta/Business Services Palpuru Ninji Kari/Health Centre Kalpa purru Wirranjarlki/Public Health Unit Piliyintinji-Ki/Stronger Families Wirlyarra punjarlki kapi Miripartijiki/Sport & Recreation 30 30 32 36 40 42 Manu Kinapina Parlpurru Ninji Kari/Regional Remote Health Service 44 POEM BY WINNIJIPURRTU NIXON 48 FINANCIAL STATEMENTS 49 Annual Report 2012/13 Anyinginyi As a Community Controlled Aboriginal Health Organisation, Anyinginyi provides primary health care services to the people of Tennant Creek and the surrounding Barkly region. Multidisciplinary and consisting of six different sections, Anyinginyi offers a holistic approach ensuring that our clients physical and emotional health and wellbeing is given the utmost priority. Our Health Service Delivery Area stretches north of Tennant Creek to Elliott, east almost to the Queensland border and south to Ali Curung, an area of almost 150,000 square kilometres. Anyinginyi Health Aboriginal Corporation adopts the following guiding principles: • Development opportunities for staff • Effective communications • Empowering individuals to take reasonable responsibility for their health • Financially responsible • Assisting to address the social determinants that contribute to the poor health status of many local people • High quality reporting, internally and externally • Community Engagement • Focus on clients • Cultural responsiveness • Respect for ourselves and all people • Respect community autonomy • Aboriginal and non-Aboriginal people working together as one team • Quality relationships, internally and externally • Outcomes focused Our History Created in 1984, our constitution then, as now, focused on the central objective to relieve the poverty, sickness, helplessness, economic disadvantage and social distress that affects the Aboriginal population, through various community based strategies and programs. In 2003 Anyinginyi Congress Aboriginal Corporation became Anyinginyi Health Aboriginal Corporation to create our own Our Vision is to be a key player in successfully “closing the gap” in the health status of Aboriginal persons in the Barkly region. distinctive identity. It was also in 2003 that the North Barkly Zone approached Anyinginyi asking us to auspice their health service funding. Increasingly Anyinginyi were also being asked by departments and communities to provide various regional programs in primary health care, health education and health infrastructure; most well known being the North Barkly Primary Health Care Program which provides GPs to our remote North communities and the Grow Well Program for the South Barkly. Since 2003 Anyinginyi has continued to run nine other region-wide based programs for the people of the Barkly, providing services such as Maternal Health, Eye Health, Substance Misuse, Mental Health Counselling, Dental, Health Promotion, Physical Health, Allied Health, and Bush Mobile to eleven remote communities. In May 2009 we began the process of Regionalisation, working toward a single service provider to administer health care services to all people of the Barkly Region. A round of consultations and a Regional Community Forum was held in November 2009 with the clear outcome that Aboriginal people living in The Barkly wanted an Aboriginal community controlled organisation to provide their health care services. In September 2010 Anyinginyi was selected to be the future sole service provider of Primary Health Care and we are currently working towards progressing this. Anyinginyi now has a large focus on Primary Health Care education through our concentrated programs such as Healthy 4 Life, Foetal Alcohol Spectrum Disorder Project, Tackling Smoking, Healthy Living and Active Life. 2012/2013 ANYINGINYI ANNUAL REPORT • INTRODUCTION 3 Annual Report 2012/13 Our Mission is to be a provider of high quality primary health care services focusing on prevention and treatment in a culturally responsive way and to empower individuals to take more responsibility for their own health. Our 2012/2013 Year The 2012/13 financial year has seen Anynginyi continue to grow as an organisation to what is now a well governed and managed independent entity that consults and listens to it’s community and provides high quality services in a culturally appropriate manner. We invite you to read this Annual Report to learn more about Anyinginyi Health Aboriginal Corporation and how we are making prevention the solution in the Northern Territory’s Barkly region. Our Governance Structure 2012/2013 ANYINGINYI ANNUAL REPORT • GOVERNANCE STRUCTURE 5 Annual Report 2012/13 Chairperson’s Report Welcome to the 2012/13 Annual Report of Anyinginyi Health Aboriginal Corporation. This is my fourth Annual Report as Chairperson of Anyinginyi and in that time I have witnessed a continuing improvement in the quality of services provided and the competency and capability of our organisation which provides a platform for further improvement in the future. Stating what a successful year we’ve had must be balanced by the fact that although in the past year there has been a small “closing of the gap” in Australia with the most improved result being in the Northern Territory, the health status of Aboriginal people remains far inferior to non-Aboriginal people and a national disgrace. Further evidence is that the health status of residents of the Barkly Region ranks amongst the worst in Australia – this has been documented in previous annual reports in the form of the highest consumption of alcohol per person in Australia and the highest percentage incidence of end stage renal disease in Australia. On the positive side one of the key advantages of being an Aboriginal community controlled service is the opportunity to be innovative and customise what is done to suit the local community. The Board has taken the position that we must be innovative to move away from just being the “ambulance at the bottom of the cliff” providing treatment, to prevent the escalating need for treatment. This position is in line with our motto that “prevention is the solution” and the belief that the “gap” will not be closed by doctors and nurses but by individuals, families and communities taking “reasonable responsibility” for their health. However that “reasonable responsibility” must be balanced by “realistic expectations”– to be more specific if an individual is living in an unsafe environment the expectation for them to take reasonable responsibility for their health reduces significantly. Anyinginyi has had some great successes in preventive programs, for example getting the message across to families and the community that one drink of alcohol during pregnancy is one too many as detailed in the FASD (Foetal Alcohol Syndrome Disorder) section of this report. Another success is the activities of our Sport and Recreation section also detailed later in this report. However the biggest impediment in improving health in our area is inadequate housing – this hits us in two major ways, firstly overcrowding which has a negative impact on the health of many residents and secondly the difficulty in attracting and retaining quality staff. The good news is we are playing our role in addressing both by running our organisation as a business producing profits, (see financial report) that can be used to improve infrastructure. In 2012/13 the profits from the prior year allowed us to self-fund two major projects: • Purchasing six new two bedroom town houses to provide accommodation for doctors, dentists and other health workers. Accommodation has long been an impediment to attracting and retaining staff and this accommodation described as “the best I have had in a remote location” by an experienced practitioner who has worked in many locations. The results for our community are substantial , for example in the past it has been difficult to attract dentists to work here however with the new accommodation it is no longer a problem –there is no longer a shortage of quality dentists for the people of the Barkly. • Reopening of the former Health Centre. In 2010 our new state of the art health centre, Palpuru Ninji Kari was officially opened by Member for Lingiari, Warren Snowdon and resulted in a 40% increase in treatments to clients. It was originally intended the former Health Centre would close however it has been refurbished, is now known as Ngalanya Health Clinic papulu and provides a great facility for eye services, dental clinic, physiotherapy, podiatry and other allied health services. The other big news is that the organisation has made a commitment to provide housing for staff requiring it. To be honest we lose a number of quality local Aboriginal staff who love working at Anyinginyi, are good at their job but end up leaving us sometimes due to social issues associated with inadequate housing. The concept is for our Aboriginal staff to develop what is required and how it will work, for the Board to consider. From early discussions with Aboriginal staff, feedback received is what is required is safe and secure housing that is well maintained provided to Aboriginal staff who are either studying or qualified. The project will be funded by the self-generated Income from 2012/13 and from future years and I believe will provide an example for other organisations throughout the Territory. In summary it has been a very successful and innovative year however there is still so much to do. I would like to thank our General Manager, Trevor Sanders and his Management team and staff for all of their hard work and efforts throughout the year to implement the Board of Directors strategic directions. I acknowledge and thank my fellow Directors and Executive for their support, commitment, vision and leadership in making Anyinginyi a truly Community Controlled Organisation. LT Chairperson - Board of Directors 2012/2013 ANYINGINYI ANNUAL REPORT • CHAIRPERSON’S REPORT 7 Annual Report 2012/13 Board of Directors LT is in the final year of her second two-year term as chairperson of Anyinginyi. A Warlmanpa woman, from 160km north of Tennant Creek, LT has lived for most of her life in the Barkly and has connections to many communities through family. As well as her role as Chairperson of the Anyinginyi Board, LT is also an Interim Board member of NT Peak body for child protection - Strong Aboriginal Families, Together (SAF,T) and a Board member of Central Australian Aboriginal Family Violence Legal Unit (CAAFLU). Child protection and family violence prevention are her passions. LT says that: “ Aboriginal Community Control means LT Napanangka CHAIRPERSON Duane has previously worked for Anyinginyi as coordinator of the Men’s Centre, then for the Council of Elders and Respected People (CERP). He now holds the position of Indigenous Engagement Officer for the Department of Families, Housing, Community Services and Indigenous Affairs. Duane sees prevention as being the solution predominately through: Duane Fraser Jakamarra DEPUTY CHAIRPERSON “ Ensuring and encouraging a healthier life style through medical support, care and education programs for all young and old! ” As a Community Controlled Aboriginal Health Organisation, Anyinginyi is governed by a Board of Directors that are elected by members of the organisation. Providing strategic direction for the Leadership Team, the Board of Directors gives a voice to all residents of the Barkly region which ensures the highest quality primary health care is provided. A member of the Anyinginyi board for seven years, Pat was born in Tennant Creek, her mother a Warumungu woman and her father an Arrente man. Pat comes to the board with 30 years experience as a health worker for the Department of Health, a Councillor for Barkly Shire and a Committee Member for the Council of Elders and Respected People (CERP). “ It’s very important we continue our role in Community Engagement especially involving working with young people for the future. ” Pat says that: Pat Braun Nungala SECRETARY A Warumungu man from Phillip Creek, Ross is a co-founder of Anyinginyi Health Aboriginal Corporation and has been involved in many different roles within the organisation throughout its history. His community participation extends beyond Anyinginyi and he has been involved with many other organisations in Tennant Creek. “ Quality Education and Housing are fundamental for our people. It leads to better health and provides the opportunity for prevention to work. ” Ross belives that: Ross Williams Jakamarra TREASURER 2012/2013 ANYINGINYI ANNUAL REPORT • ANYINGINYI BOARD OF DIRECTORS 9 Annual Report 2012/13 Board of Directors Mary is a Walpiri woman originally from Ali Curung and sits on the Board as a representative for Elliott. Mary has had much involvement with Anyinginyi over the years including previous terms as a Director and working as an Aboriginal Health Practitioner. Mary firmly believes that there needs to be: “ More education in the communities.” Mary James Napangarti A Jingili woman from Elliott, Janet has family links throughout the Barkly. She has a background in primary health, working as a health worker in Elliott, Alice Springs and Ali Curung during the 1980’s. Janet resigned from the Board of Directors in December 2012 when she moved out of the area. In response to how she sees prevention as the solution Janet says: “ By Anyinginyi taking the lead and putting in initiatives that are appropriate for Aboriginal people in the Janet Gregory Barkly region [that allow us] to take control of our Napanangka own health. Prevention is the answer, the only way. ” RESIGNED Elliot McAdam As a former NT Cabinet Minister, Elliot is a Board representative for Tennant Creek and brings with him a wealth of knowledge and experience in governance and management. Ronald is a Warumungu man from Tennant Creek who has been involved with Anyinginyi in various roles, from employee to Director, since its establishment in the 1980s. “ Prevention IS the solution, we need to look after ourselves now before it is too late to do anything.” Ronald believes that: Ronald Plummer Japururrla Gordon is a Warumungu man from the Barkly Region and lives at Rockhampton Downs in the Barkly Tablelands, representing the community of Wogyala. As a community member, Gordon’s passion is ensuring his people get the best health services available as: “ There are a lot of our people sick - out bush and also in town.” Gordon Noonan Jampa Jimpa Jungarayi Jeffrey is the Board representative for Marlinja and has been on the Anyinginyi Board since the start of 2012. 2012/2013 ANYINGINYI ANNUAL REPORT • ANYINGINYI BOARD OF DIRECTORS 11 Annual Report 2012/13 Board of Directors Barbara is a Warumungu woman who has lived most of her life in Tennant Creek. She joined the Board of Directors in May 2013 and is passionate about the need for the community to make changes. She is a traditional woman and Respected Elder who has been nominated in the NAIDOC awards for her leadership role and contribution to community. “ Life is precious for each of us as individuals and together as a community. People need to educate themselves throughout their life journey to make Barbara Foster Nungala a better life and better future. ” Barbara believes that: Sheila is a Kurundi woman who has lived most of her life in Tennant Creek. She is a Respected Elder, interpreter and counsellor within the community. Sheila joined the Board of Directors in August 2013 as a traditional woman who deeply cares for her community. “ People need to listen to the wisdom of the Elders to keep the community strong and healthy. People need to wake up to the need to educate themselves Sheila Johnson about health, live responsibly and help others. ” Sheila says that: Nungala Winnijipurrtu Jalajirrpa Winnijipurrtu Nixon was born at Munga Muntta Mission (Phillip Creek) in 1947 and a very respected Elder for young and old, Wumparani and Papulanyi. Winnijipurrtu Nixon could speak: Warumungu, Warlmanpa, Alyawarre, Kaytetye, Walpiri and a few more, including an Indonesian language! Winnijipurrtu Nixon has a son, Kevin Nixon (Nicko) her sisters and many other daughters/sons, grandchildren and great grandchildren. Winnijipurrtu Nixon was a founding member of Anyinginyi Health Aboriginal Corporation (AHAC), Papulu-Apparr Kari (Language Centre) and a member of the Australian Literacy and Numeracy Foundation – keeping language strong. Winnijipurrtu Nixon has written a Warumungu Dictionary and many story books. Winnijipurrtu Nixon has worked at AHAC as an Aboriginal Health Worker and Language Centre as a cultural advisor, interpreter/ translator and taught Cultural Awareness training. She had also taught at the schools so students could learn, understand, read and write Warumungu. Winnijipurrtu Nixon poured her heart and soul into language and culture and loved to teach people. Kirriljintjarra Kapi ngattujintjarra Kariny ngalakanya Manu Kuna (Barkly Region) Kina Kapi yirrarrujinini warrarripuyuyu - karmantta. Very loved and deeply respected elder throughout the Barkly Region and will be sadly missed - Karmada 2012/2013 ANYINGINYI ANNUAL REPORT • ANYINGINYI BOARD OF DIRECTORS 13 General Manager’s Report • Adopting an innovative approach, for example providing excellent accommodation to assist with attraction and retention of staff; engaging local school students to develop a hip hop video to promote non-drinking of alcohol during pregnancy It is a privilege to be General Manager of Anyinginyi Aboriginal Corporation. 2012/13 has been a successful year on a number of levels for Anyinginyi but there is still so much to be done. The achievements are detailed in other sections of this report so without going into detail I will just highlight a few: • Continuing to build the competency and capability of Anyinginyi – it is essential in our sector to have the confidence of our community and funders • Excellent financial management that allows investment into infrastructure, improving services • Establishing a system that provides meaningful employment for Aboriginal people including a transition from work experience and work based apprenticeships while at school to employment at Anyinginyi • Supporting the local community, be it assisting Little Athletics to compete in state titles in Adelaide, driving and financially supporting NAIDOC week, successfully lobbying to have Pulkapulkka Kari Nursing Home air-conditioned; expanding sport and recreation services or providing better health services The achievements of 2012/13 have increased our ability to move further forward with a number of new goals already set by the board, including “employment housing” and increasing the commitment to quality by progressing to organisation wide accreditation. In closing I would like to thank our Chairperson, LT in particular and the Board in general for their support, guidance and direction. Also a big thank you to a great group of Section Managers and to all staff for their commitment, achievements and support. Trevor Sanders General Manager Annual Report 2012/13 Director of Clinical Services Report Dr Rosalie Schultz, Director of Clinical Services left Anyinginyi this year after a dedicated 20 months in the position. We would like to acknowledge her contribution to improve Aboriginal health services. Dr Schultz created a platform for Anyinginyi to continually improve clinical services. Data Systems Management and Continuous Quality Improvement Fundamental to all our clinical activities, research and measurement of our communities’ health, is the need for good clinical data. In the past year we have been dedicated to improving the quality of clinical data. Focusing on Children Our six monthly reports include three key performance indicators of child health; fully immunised children, underweight children, and Anaemic children. FULLY IMMUNISED CHILDREN Making sure our children are all up to date with immunisations is very important to us as this ensures that children are not at risk of getting childhood diseases and prevents disease outbreak in the community. Over the last year we have worked to improve immunisation recording and recall, this contributes to children accessing the clinic for their immunisation. This improvement has led to very good outcomes on our immunisation status for children. When we report on our patient numbers no personal information is ever given out. However we need to report on our data for a number of reasons, here are some: • To understand why our clients are coming to the clinic and for what reasons • To count how many clients are coming to the clinic so we can monitor numbers and make sure we have enough clinicians to see people • To report to our funding bodies so they understand what problems our people are experiencing, e.g. how many people have diabetes and other chronic conditions • To make sure all our clients are getting the right treatments like children, men and women health checks, and immunisations etc • To help us with research projects and continuous quality improvement (we can’t improve something without understanding the problem first, data helps us to do that) 2012/2013 ANYINGINYI ANNUAL REPORT • DIRECTOR OF CLINICAL SERVICES 15 Annual Report 2012/13 Director of Clinical Services Report Percentage of fully immunised children in the Barkly Region. 12 to 23 month olds 6 to 11 month olds 9% 14% It is a good idea to come into the clinic when the bus driver says you need to come in. Parents and carers need to make sure their children get their regular checks and needles. Come into the clinic after your child is born, 2 months, 4 months, 6 months, 12 months, 18 months, 4 years and whenever your child is sick or you want a check-up. If your child is given a needle somewhere else we are given this information from the NT Immunisation register. We put this information into our Communicare system. When we give a needle we send this information to the NT immunisation data base. They keep a record of your child’s immunisation. A nurse at the clinic is responsible for checking to see if a child is due to have their needle and if the parent or carer has not brought the child in the nurse will ask the bus driver to pick them up to come into the clinic for their needles. NOTES TO PARENTS AND CARERS Our data for the last year is very good, however there are still some children not coming in on the bus or coming in on time for their needles. 69% 2 to 6 year olds 8% not immunised WHAT WE DID TO IMPROVE The clinic team worked very hard to ensure that all children who come to our clinic have an up to date electronic immunisation record, which includes a recall for immunisations that are due in the future. Parents and carers may notice that our clinicians always ring up and check to ensure that a child’s immunisation record is correct before they give a needle. Improving immunisation timeliness in young children is important to us to reduce the risk of getting preventable childhood disease. UNDERWEIGHT CHILDREN We have a trend of consistently measuring about 75% of our children each year. 5% of the children we measure are underweight. When clinicians find children underweight they will give advice to parents and carers on what can be done to improve the child’s weight. This might mean your child needs to take medicine, and have a good healthy diet. The child’s weight will be recorded each time the child is weighed. NOTES TO PARENTS AND CARERS When you bring your child into the clinic ask for your child to be weighed. Come back to the clinic if the nurse or health practitioner want to see you again to check on your child’s weight. CHILDHOOD ANAEMIA Our KPI data shows that we have tested 60% of our children who are between 6 months to 6 years of age. This data shows that testing for anaemia in children has improved by 10%, which shows we are still working on improving our coverage rate. However, this also means that we have found more children who are anaemic. We still have many children that need to come to the clinic to be tested and monitored. Our staff are constantly being in-serviced to ensure that: • The right technique is used to test children • Results are entered in Communicare • Regular checks of the Hemocue monitor • Use of CARPA guidelines NOTES TO PARENTS AND CARERS To prevent anaemia: • Have regular checks at the clinic • When you are pregnant eat a healthy diet high in iron it will make your blood strong • Breast feed your baby for the first 6 months and then after 6 months try to continue and give other age appropriate foods Moving forward to 2014 ORGANISATION ACCREDITATION Up until now the Health Centre was the only section to be subject to a nationally recognised Accreditation process. However Anyinginyi has now committed to organisational accreditation meaning all of our sections will be subject to a Nationally recognised accreditation process – another step to improving quality at Anyinginyi. CARE COORDINATION AND SUPPLEMENTARY SERVICES PROGRAM Anyinginyi has recently received funding to establish a program to assist care coordination and supplementary services. A Care Coordinator will be employed to facilitate this program and work with clinicians to ensure that we have a system for care coordination for those clients who have a chronic disease on a care plan and need special needs and access to supplementary services. TELEHEALTH Anyinginyi has recently received grant funding to assist in the implementation of Telehealth processes. Telehealth will be introduced to Anyinginyi, this technology will be useful for some clients for some specialist reasons. Clients will be able to have a consult with a specialist without having to go to Alice Springs. • Foods high in Iron every day • Best foods are liver and kidney, red meat, chicken and fish • Bread and cereals (especially whole grain or iron fortified green vegetables (fresh) tinned, or frozen, egg yolk (over 8 month) dried fruit • Foods high in vitamin C with meals to help iron to get into your blood 2012/2013 ANYINGINYI ANNUAL REPORT • DIRECTOR OF CLINICAL SERVICES 17 Annual Report 2012/13 UPDATE The second year of the Anyinginyi FASD Project began with optimism, despite a cut in funding which meant that Leonie Williams, Project Officer, moved on to other roles within Public Health, while retaining some connections with the Project. The Federal Government completed its inquiry and report into FASD (“FASD: The Hidden Harm”) and there has been hope for increasing national awareness. During the year, the FASD Project continued to develop its resources locally, with a training package for teachers being piloted in Tennant Creek, then further rolled out as a generalised, multimedia, flexible training package for communities. We have just received funding to send this out to all remote communities in the Barkly Region, thus offering training to multiple stakeholder groups: teachers, health professionals, parents, teenagers, Elders. Our growing collection of professional-quality puppets have become an extremely valuable resource for both education and breaking down barriers. We have recently undertaken a film project with the puppets, involving Anyinginyi staff and clients in script-writing, characterdevelopment, and puppet operation. Through some generous funding from the Foundation for Alcohol Research and Education (FARE), this project will culminate in a film launch and community forum in September, 2013. FASD Project Co-ordinator, Adele Gibson, has continued to provide as much education and awareness-raising as possible with various groups, both within and outside the Barkly; and has also provided support to individual referrals as required. In February-March, 2013, AHAC Chairperson, LT, and FASD Project staff, Leonie Williams and Adele Gibson, travelled to Vancouver, BC, Canada, to present at the 5th International FASD Conference. Over five fantastic and jampacked days, we were part of a global group of 700 delegates from 26 countries. We attended sessions such as FASD and the Law; parenting; prevention; the Kimberley prevalence study; Foetal Alcohol Spectrum Disorder Project epidemiology; transgenerational trauma; and various types of research and treatment. Our presentation, a 90-minute session entitled “A Story of Ownership and Empowerment: Engaging Indigenous Communities in the Australian Northern Territory on the Issues of FASD” used a storytelling approach to showcase the strengths as well as the challenges of FASD in the Barkly Region. As well as the important new knowledge and connections we all made at the conference itself, our two visits to Canadian FASD programmes were equally valuable. We were invited to visit Terrace community, which is a town on the banks of the Skeena River, about an hour’s flying time from Vancouver. The feedback from delegates was very positive, with many people creative approach - using music, videos, stories, puppets and so on. We had an amazing day there, visiting the Kermode Friendship Centre, being welcomed as honoured guests with a traditional banquet, learning about their First People’s culture and the holistic healing programmes they have been using effectively for over twenty years. The Terrace community have extended the hand of friendship to the Barkly communities, and hopefully, this valuable connection will continue into the future. We also visited an urban facility in downtown Vancouver, called Sheway, another effective and holistic programme aimed specifically at supporting Aboriginal women with substance use problems through pregnancy and early child-raising, in a non-judgmental, harm reductive way. By addressing all the issues encountered by their clients, including housing, poverty, health, education, child care, etc, this centre has had particular success in reducing FASD over a period of twenty years. We learned a lot from these supportive, holistic models. 2012/2013 ANYINGINYI ANNUAL REPORT • FASD PROJECT 19 UPDATE UPDATE HEALING BUSH MEDICINES Makati has black cherries that are eaten and the leaves are boiled like tea to drink. Helps with blood pressure, diabetes, kidney function. Marnukkujju black cherries are eaten and the roots boiled then gargled for gum infections and tooth aches. Karlkkati seeds grow in bunches. Rubbing a bunch in your hands forms soapy suds you can use as a mild antiseptic. Annual Report 2012/13 Bush Tucker & Medicine Education Many plants are used by Indigenous people in everyday life, in fact nearly every plant and animal in Australia has a purpose in the social and emotional wellbeing of all Indigenous people from here. During the year we have had the opportunity to provide many smoking ceremonies and below are some that have been completed: • Barkly College in-conjunction with the Stronger Sisters Program • Mother and son at the IFSS house and • During the Drug Action Week at the Women’s Camp at Kunjarra (Pebbles) It’s through dispossession of their lands and conveniences of society that we have a high rate of chronic disease in Aboriginal Australia. Piliyintinji-ki’s Women’s Centre collects bush medicine and bush tucker when it is available depending what is in season. We have regular sessions of ‘smoking’ (healing) which is a traditional ceremony. For the ceremony we use some of the local plants and bush wax that is available year round in our area. This smoking process is used for health, healing, strength, and general lively-hood at any time of the year. Our program attracts ladies from all over the Barkly region who have come to Tennant Creek to access the services here, that are not available from their own places of residency. The bush medicines we collect are used by the ladies and extra is made for the rest of the community and is in demand at the moment due to winter. The Cultural Reconnection (Healing) Program is an important part of Social and Emotional Wellbeing, as we are healing ourselves with our own medicines. The 3 plants used are Mulurr, Mungkarijja and Mungkartta, combined with Yakurla. All of the plants can be used for other medicinal purposes such as skin infections. 2012/2013 ANYINGINYI ANNUAL REPORT • BUSH TUCKER & MEDICINE EDUCATION 21 Annual Report 2012/13 HIGHLIGHT NAIDOC Week in Tennant Creek has a long reputation as being one of the best, most enjoyable celebrations in the Territory and this year was no different. The theme for NAIDOC Week 2013 was We value the vision: Yirrkala Bark Petitions 1963 proudly celebrating the 50th anniversary of the presentation of the Yirrkala Bark Petitions to the Federal Parliament. Asserting title to Yolngu country under Yolngu law, the petitions were the first traditional documents recognised by the Commonwealth Parliament and helped to shape the nation’s acknowledgment of Aboriginal people and their land rights. The petitions were an important milestone in the land rights struggle in the NT and are still being built on with the hard work of people all around Australia who are fighting for country. The commitment and dedication of the Warumungu people past and present to Aboriginal rights is a proud achievement. The NAIDOC Parade was held on Tuesday the 9th of July to coincide with Nyinkka Nyunyu’s 10th Anniversary. Nyinkka Nyunyu is the much loved Cultural Centre for the Waramungu people and sacred site where our march traditionally ends and the celebrations begin. As always the preparation for the march is a wonderful thing to see. The children moved from rally point to rally point gathering balloons and face-paint as they went and joined the adults to march proudly after the NAIDOC banners. Surrounded by the culture of the region and in a sacred space the NAIDOC Week Ceremony began with a traditional Welcome to Country by Mr Ross Jakamarra Williams. Moving speeches were given by Anyinginyi Director Elliot McAdam and Gerry McCarthy. Then Directors Elliot McAdam and Ronald Plummer presented the 2013 Tennant Creek NAIDOC Awards. This year a special category was added to allow for outstanding staff members of Aboriginal Organisations to be recognised. Our own Solomon Lewis from the Stronger Men’s section was this year’s Anyinginyi recipient. After the Awards Ceremonies everyone sat back and enjoyed a hearty bush stew while being entertained by musicians and traditional dancers. NAIDOC Week Celebrations This year’s events were designed to bring the Elders together with the children, and were a wonderful success, especially Storytelling at the Dam. This year’s events were designed to bring the Elders together with the children, and were a wonderful success, especially Storytelling at the Dam followed by child and youth discos. One of the most loved events of the week is the Elders Day Brunch. Over 150 Elders came together for a terrific celebration. This day is all about honouring our Elders. The Elders shared a meal, a laugh and stories while music was supplied courtesy of the Winanjjkari Allstars Band. The NAIDOC Week’s events show our strong and valuable partnerships with other Aboriginal and Government organisations and the wider community in Tennant Creek. For example 8 local girls served the meal, staff from Anyinginyi, Julalikari, CERP, Catholic Care, HACC and YDU attended to the preparation and running of the event while the Barkly Shire Council provided the venue. The Traditional Elders Past and Present Football match was run on Monday evening and won by Ali Curung. Then on Saturday we finished the week with the traditional Mr Frank Trophy Football Match between the Janapurlalki Eagles and YDU. The Janapurlalki Eagles won on the day and everyone enjoyed the afternoon in the beautiful winter sunshine. 2012/2013 ANYINGINYI ANNUAL REPORT • NAIDOC WEEK CELEBRATIONS 23 Annual Report 2012/13 HIGHLIGHTS Staff Achievements NT ADMINISTRATORS AWARD - INDIVIDUAL HEALTH CARE Adele was nominated by colleagues for her work delivering a comprehensive health promotion program to reduce the prevalence and impact of foetal alcohol spectrum disorder (FASD) in the Barkly region. AUSTRALIA DAY CITIZEN OF THE YEAR AWARD This year our own Secretary of the Anyinginyi Board was honoured for her tireless commitment to community with the 2013 Australia Day Citizen of the Year Award. Pat is well known to Anyinginyi having been a founding member of our organisation. Pat has been an inspiration to all with her devotion to people, their needs and an unswerving vision for change. Adele has empowered young people Pat gives a voice to the people, leads individually and collectively to understand the impact of FASD each individual to take the steps so they can develop their own needed to bring about real change strategies for preservation. in their life. Her key activities have included the development of an educational video about FASD by young people, and she has presented on this topic to an international forum. Her efforts have contributed to heightened awareness of FASD not just throughout the NT but Nation wide. Congratulations Pat. We are proud that you are our Director. The Smoking Program KalpaTackling purru Wirranjarlki The Tackling Smoking Program began in April 2012 and has gone from strength to strength, co-ordinated by Clare Anderson and two Tobacco Action Workers. Developing a powerful brand and message was the first priority. Once the brand and logo were developed, resources were purchased, displaying the unique Anyinginyi Tackling Smoking brand. The messages about not smoking coupled with resources, such as, hats, beanies, frisbees water bottles, balls, car and house stickers, have been popular with communities in the Barkly Region. ‘Talking about the Smokes’ is a national project, researching Aboriginal people’s habits, knowledge and attitude toward smoking. It is a two year project managed by Menzies, NACCHO, CEITC and the Cancer Council of Victoria. Aboriginal Community Controlled Health Services (ACCHS) across Australia, including Anyinginyi were invited to participate. Two Aboriginal research assistants were employed, Travis Alum and Lorraine WardLewis, to conduct the survey over six weeks during November and December. In March, 2013, the local results of the ‘Talking About the Smokes Project’ were released, giving researchers and the Tobacco Team useful information about patterns of smoking in Tennant Creek and within AHAC. This research project will be ongoing, with Wave 2 planned for later in 2013. Other highlights for the Tobacco Team during the year have included attending the first national meeting organised by Menzies and Lowitja Institutes on “Use of incentives to stop smoking in pregnancy among Aboriginal and Torres Strait Islander women.”The report is expected before the end of the year. The Tobacco Team identified a significant rate of chewing tobacco being used in the local community and as a result a community group has been formed to come up with ideas for a painting to address this problem. It is planned to make the painting into a poster and circulate throughout the Barkly Region. In June, 2013, Shellie Morris came to town for a week to run a combined workshop for young women (Stronger Sisters) and older women (Stronger Families Women’s Centre). The group had a great week, working together to produce a song and video called “Respect Yourself” – around having healthy pregnancies and healthy babies, not smoking or drinking while pregnant. To view the video, go to P:\videos\Respect Yourself Video2.wmv 2012/2013 ANYINGINYI ANNUAL REPORT • TACKLING SMOKING PROGRAM 25 HIGHLIGHT Sylvia Palmer continued in the position as the Trachoma Elimination Program’s coordinator for the Barkly region. Sylvia has screened approximately 80% of school children in 12 Barkly communities and Tennant Creek Primary school for acute Trachoma.The prevalence of Trachoma in children in the Barkly has fallen from 24% in 2010 to 6% in 2012. • All children with Trachoma and their households received antibiotic treatment and where prevalence was over 10%, the whole community was treated. The prevalence of Trachoma in children in the Barkly has fallen from 24% in 2010 to 6% in 2012 • Most Barkly schools now have a face washing program and Trachoma promotional posters are in every school and health centre. • Milpa, the Trachoma mascot, has visited every remote community in the Barkly as far away as the small community of Kiana – promoting the ‘clean faces – strong eyes’ message. • Initiated and assisted improvement of ‘trachoma’ and trichiasis clinical items in communicare. • In November 2012 Professor Taylor, world renowned leader in Trachoma elimination and head of the Indigenous Eye Health Unit at Melbourne University, visited the Anyinginyi Eye Health Unit with eight influential philanthropic sponsors of the Trachoma elimination fund. Cathy Malla and Sylvia took the VIP’s to Ali Curung and Mungkarta. They were all very impressed by their visit to the Barkly region. • In November 2012 Sylvia took women from Mungkarta and Epenarra to a CAAMA Radio Trachoma promotion launch in Alice Springs. The Trachoma murals from Mungkarta, Annual Report 2012/13 Trachoma Elimination Program Epenarra and Murray Downs were chosen for the launch’s invitation. This event was organised by the Indigenous Eye Health Unit at Melbourne University. Audrey and Louise Rankine spoke on how they teach their children to wash their faces to keep Trachoma away. • Introduced singer/songwriter Shellie Morris to Murray Downs community where she created a song with the school children about feeling good about their community and country. • Employment of two Community Based Workers in Ali Curung and Murray Downs through the Fred Hollows Trachoma Elimination Fund. AHAC acts as the host agent for this fund and the workers are supported by Sylvia. The fund is also used to engage community members to assist with school screening, treatment and Trachoma promotional activities. • Yamba and Jacinta performed together with our own Milpa at the Tennant Creek Primary School in April 2013. • Four Melbourne Demons AFL football players visited Tennant Creek to run a football clinic at the same time promoting Trachoma messages through hygiene stations. This event was organised through the Indigenous Eye Health Unit (IEHU) in Melbourne and sponsored and hosted by AHAC. The event was a great team effort by various AHAC section members, local individuals, government and nongovernment service providers from Tennant Creek and Alice Springs and two members of the IEHU, all brought together by Sylvia. Approximately 150 children had a great day and took home a few hygiene messages. 2012/2013 ANYINGINYI ANNUAL REPORT • TRACHOMA ELIMINATION PROGRAM 27 Annual Report 2012/13 Primary Health Care Delivery Model As a leader in health care we provide the following services: Primary Health Care Ear Health Eye Health Child and Maternal Health Physical Fitness Podiatry Physiotherapy Nutrition Chronic Disease QUIT Smoking Substance Misuse Counselling Bring Them Home Public Health Education 2012/2013 ANYINGINYI ANNUAL REPORT • PRIMARY HEALTH CARE DELIVERY MODEL 29 Annual Report 2012/13 Nyangirru Piliyi-ngara Kurantta One of the primary functions of Nyangirru Piliyi-ngara Kurantta/Business Services is to provide administrative support to the elected Board of Directors in their role of governance for Anyinginyi Health Aboriginal Corporation. Further to this, Business Services provide management and administration support, including finance and payroll, human resources, grants management, general administration, information technology, complaint resolution and public assistance to the other Sections. Additionally Business Services manages all infrastructure, assets, stores, maintenance, upgrades and supply. “ One of things I always say about Business Services is that we are always on the move, new projects, new policies, anything and driven by community or government. ” Clarissa Burgen SECTION MANAGER BUSINESS SERVICES REPORT In 2012/2013 we completed the infrastructure management of the Allied Health building and started the renovations on the Regional Remote Health Complex in Paterson Street. These project have focused on using where possible local trade companies and employment of local persons, personally I am proud of our annual activities in both commercial and housing development for Anyinginyi and our contribution to the local economy. Being a part of Business Services allows staff to support our client service Sections be it through funds seeking, policy change, staff management or contribution to Strategic direction, we appreciate the role we contribute in governance to allow staff total program focus. The most exciting project started in January and continuing in 2013/2014 will be Anyinginyi’s goal to provide organisational housing to our local employees subject to their employment. Not only will this be a first for Anyinginyi in supporting both cultural and regional needs but a first for staff in experiencing a mutually obligated responsibility of employment and housing. I look forward to reporting in 2013/14 on the lessons learned and outcomes. Another major activity was the re-negotiation of our Enterprise Agreement with Staff. Staff will receive a 2.5% increase each financial year for the period 2013 to 2015; impacts the ability of Anyinginyi to offer competitive wages are always an issue however we as on organisation respond as needed. Anyinginyi again cleared our Financial Audit and I thank the hard work of Nova, Kaylene and Janelle and Centre Accounting for maintaining the solid and transparent financial status of our Organisation. Our Section greatly appreciates the positive relationships we have with our funding bodies, local government and non government entities, and our clients in addressing the service needs of the Barkly Region. As always our doors are open for any questions. Looking to 2013/2014, we are committed to continually improving our governance, sustaining health investment in the region and providing local skills development with long term career gaols. My thanks to a wonderful Business Services Team. Staffing saw arrivals and departures and I thank everyone for their commitment to the team. Congratulations to Tony Miles for attaining his Diploma in Business (Governance). 2012/2013 ANYINGINYI ANNUAL REPORT • NYANGIRRU PILIYI-NGARA KURANTTA/BUSINESS SERVICES REPORT 31 Annual Report 2012/13 Palpura Ninji Kari and enables our clients to build meaningful relationships with their health care provider. Of course we still rely on and value the role of locum Nurses, Specialists and GP’s when needed however it is an indicator of the status of the Health Centre and the warmth of the community when we can attract permanent staff to join us. Below is a snapshot of some of the activities in the Health Centre over the past twelve months, provided by staff working in the various programs. We look forward to another challenging but satisfying year. Allan Baldock Director of Health Services Practice Nurse Manager’s Report A word from the Director of Health Services Providing Primary Health Care services in remote Australia is very challenging. The burden of chronic disease in our remote communities is sadly very high and those employed in this sector have to be very dedicated to work in such an environment. We are fortunate at Anyinginyi Health that we have a dedicated team, which includes our Administration staff, Nurses, Transport drivers, Aboriginal Health Practitioners, Environmental officers, and General Practitioners. They all work co-operatively to provide a health service that meets the standards for “Best Practice” and the expectations of the community. We have been fortunate this last year to attract more permanent staff to many positions within the health centre, which provides stability Palpuru Ninji Kari/Health Centre continues to provide primary health care services to the Tennant Creek and Barkly Shire Community with average patient attendances of approximately 73 patients a day. It has been another busy year for the Health Centre with our Clinicians also having specific health portfolios to manage. As is often the case in Remote locations we have to say goodbye to a member or members of staff and this year we farewelled our hard working Medical Director Dr Rosalie Shultz and look forward to recruiting to that position soon. We also recently welcomed our new Director of Health Services Allan Baldock, who manages both the Health Centre and the Regional and Remote Health Section. Allan has been with the organisation since February 2008. Dr Carville Tolson remains our very popular permanent GP and we welcomed Dr Adam Huber, employed on alternate months. HEALTH CENTRE REPORT Where possible locum Doctors and Nurses are used if we are short-staffed. The Health Centre continues to be supported by visiting specialists that regularly visit Tennant Creek to conduct clinics and review clients. The Health Centre also maintains strong professional links with Tennant Creek Hospital for referrals, emergency and after hours care. The Health Centre now has the following clinical staff: Women’s Health Linda O’Halloran Diabetes Chronic Disease Nurse This program is funded by “Closing the Gap” funding and has 376 currently diagnosed Diabetic clients enrolled in it. In the last 12 months 269 “Annual Cycle of Care” management plans have been completed; and 243 clients have been registered with the National Diabetes Scheme, a marked increase on last year’s figures. The rate for patients receiving . Overall, we have had positive improvements in the care of our Diabetic clients. Examples are: • HbA1c. This test is used as a guide to what your average blood glucose level during the past three months has been the National guideline for a healthy HbA1c < than 7%. For our Diabetic clients at the time of reporting 41.8% had an HbA1c < than 7% compared to last year when the figure was only 27.6%. • Cholesterol. Too much cholesterol in your blood stream can lead to cardiovascular disease. The National guidelines for healthy cholesterol levels in < 4. For our Diabetic clients at the time of reporting 25.8% had cholesterol levels < 4 compared to last year • Blood Pressure. The excessive pressure on your artery walls caused by high blood pressure can damage your blood vessels, as well as organs in your body. The National guideline for healthy blood pressure is 138/80. For our Diabetic clients at the time of reporting 38.8% had an average blood pressure < 138/80 compared to last year when the figure was only 28.1%. Lynda Moynahan Renal Chronic Disease Nurse Lynda has been working in Tennant Creek since Feb 2013 and transferred from the Tennant Creek Renal Unit to provide care for clients with Chronic Kidney Disease prior to commencing dialysis. Lynda has had considerable experience in renal nursing in various Hospitals in NSW and Queensland and settled into the clinic as part of the clinical team, and has plans to develop the role by providing some education sessions. 2012/2013 ANYINGINYI ANNUAL REPORT • DIRECTOR OF CLINICAL SERVICES 33 Annual Report 2012/13 Palpura Ninji Kari Elizabeth LeNoble Women’s Health/ Child Health Nurse Lizzie previously worked here periodically over 3 years as a Midwife and in children’s and women’s health. working in the Middle East, Britain, and Ireland. His responsibilities run across a broad spectrum of health provision, which is primarily focused on serving the health needs of the local Aboriginal community. She will be carrying out “Well Women’s Checks” including pap smears, mammograms, pre-pregnancy consultations, management of menopause, and lifestyle issues. With the high incidence of diabetes, kidney disease, cardiac disease and STI’s, as well as giving appropriate treatment, care and follow up, Leo uses every opportunity to provide information, advice and education to his clients, as he believes firmly that primary health care is all about maintaining good health practice, and prevention of illness. He works in closely with the other staff in the clinic, in particular liaising with the drivers who are the most direct means of contact with the community. Lizzie is also our Child Health nurse and will be conducting “Child Health Checks”, immunisations, and Child Health days. Swati Pal Child Health Enrolled Nurse Swati has recently joined the Health Clinic as support to the Child Health Program. Marjorie Paterson & Rhonda O’Keefe Aboriginal Health Practitioners As long term staff members, Marjorie and Rhonda provide Indigenous Clinical Care and offer cultural support to new and existing staff. They both contribute to the Immunisation Outreach Program for Fluvax and the Child Immunisation program at Peko Park and provide valuable clinical support to the other clinicians. They also play an important role in providing positive links to our community families. Rhonda believes the best thing about working at the Health Centre is staff friendships, and her goals are to encourage other young people to consider Aboriginal Health Practitioner training. Men’s Health Leo Curran Sexual Health Screening Leo has been working with Anyinginyi since January 2011. Before this he had spent time Alan Wilson Immunisations Alan is a long term employee of Anyinginyi who transferred from Regional and Remote Health Section to the Health Clinic. He provides clinical care to the Men’s Programs and also manages the Immunisation Portfolio. Alan is extremely proud of the recently conducted ‘Fluvax Fridays’ held in Peko Park which resulted in 1140 (62%) of Anyinginyi clients receiving vaccinations for the year so far. Immunisation is an effective method of disease prevention and is well supported by the clinic. Dinesh K Jose Rheumatic Heart Disease Dinesh joined our health team in April. In partnership with Rhonda, they manage the Rheumatic Heart Disease (RHD) portfolio and we are very pleased to say that clients are presenting regularly for their treatment, with our recall rate improving on last year’s figures. HEALTH CENTRE REPORT The clinic is also in partnership with the Menzies School of Health in Darwin as part of the Secondary Prophylaxis Program. This program is looking at the benefits of administering regular antibiotic injections to patients after an initial bout of rheumatic fever in order to prevent the development of the disease. And this year we will welcome the AGPAL Accreditation assessors to our health centre. Our mission at Anyinginyi is to be a provider of high quality Primary Health Care and to focus on treatment in a culturally responsive manner. Travis Bruce Aboriginal Health Practitioner Our Male Aboriginal Health Practitioner Travis joined the Men’s Health Team earlier this year. Travis is helping to develop a Men’s Health Program at Piliyintinji-ki where he visits weekly offering support and advice on health issues to our local men in a culturally sensitive manner. The Rest of the Team Our Health Team would not be complete without the Administration and Transport Staff and the valuable support they provide to the clinicians and the public. Our Team’s commitment to quality ensures that we are adopting Best Practice Principles based on the RACGP Standards for General Practice. The Health Centre is an accredited facility. Accreditation is an independent recognition that the organisation meets requirements, criteria and standards expected of a health service such as ours. It also provides assurance for the Anyinginyi Health Aboriginal Corporation Board, Health Service Staff, funding bodies and consumers about the quality and performance of our service. All our staff has worked hard to maintain OH&S standards, a high standard of education and training, and clinical and quality standards. A recent Patient Satisfaction Survey (of 90 clients) showed that we have made significant improvements over the previous year. Although there is always room for improvement, the survey shows that at least 70% of our clients felt comfortable, satisfied, and reassured when visiting the clinic; and 80% felt respected, and warmly greeted. Our waiting times can still be problematic but this is difficult to address. Many patients attend with complex problems and multiple diagnoses, which results in more time being needed for each consult. This is a symptom of the burden of poor health within our community and we try not to turn anyone away. We are very proud of the Anyinginyi Health Centre, its staff and the work they do. It is a lovely, clean and safe environment for staff to work in and for patients to visit and thanks go out to a wonderful Health Clinic team. Pam Shoobridge Practice Nurse Manager 2012/2013 ANYINGINYI ANNUAL REPORT • DIRECTOR OF CLINICAL SERVICES 35 Annual Report 2012/13 Kalpa purru Wirranjarlki Providing health promotion, education and prevention programs, the Public Health Unit incorporates the Trachoma Program, the Tobacco Program and the Foetal Alcohol Spectrum Disorder Project, as reported upon separately. Over the past year, this section has seen many changes and great development. As well as ongoing programs, such as skin health, eye health and community events, the Public Health Unit now incorporates a Diabetes Education programme, a Youth Health Worker, an Indigenous Outreach Worker - Chronic Disease, and an expanding Tobacco Project/Healthy Lifestyles Program. Midway through 2013, Public Health swelled to 18 staff working across multiple health areas. Eye Health Programme The Eye Health Team, led by Co-ordinator, Maree O’Hara, continues to power on, delivering essential services to the Barkly Region. In just a six month period, optometrists saw 571 people and the opthamologist saw 140 people in clinics held in Tennant Creek, Ali Curung, Elliott, Canteen Creek, Epenarra, Lake Nash and North Barkly. Screening for eye conditions has been provided at multiple sites, including schools, the nursing home and the Barkly Work Camp. The Co-ordinator also assisted with surgical blitzes at Alice Springs and Katherine Hospitals, and continues to provide a model of eye health care within and beyond the Barkly Region. The Eye Health Team also participates in health promotion activities with “Iris” the Eyeball, and has made and promoted the DVD “Looking Good,” made with funding from the Fred Hollows Foundation, Rebel Productions and members of the Elliott community, to great community acclaim. Public Health Nurse Public Health Nurse, Sharon Morunga, has continued her focus upon Healthy Homes, Healthy Children and reducing the rate of skin diseases in communities. She also initiated the very effective public vaccination program which has become a very successful partnership between all sections of AHAC and has achieved an unprecedented rate of flu vaccinations in the Tennant Creek community in 2013, thus significantly reducing the vulnerability of this community to seasonal flu viruses. The Public Health Nurse has played an integral role in health promotion activities for the year, as well as involvement in the Child Health Days, regularly visiting remote communities PUBLIC HEALTH UNIT in partnership with various activities: an integrated service delivery approach, including environmental health, housing, dog program. Diabetes Educator Diabetes Educator, Jayasree Subi, started work mid-2012 and quickly established important links outside of and within Anyinginyi. She has provided fortnightly education in the Piliyintinji-Ki Women’s Centre; education for external health and social services in Tennant Creek and beyond; staff education; clinical audits; individual client consultation; and liaises with doctors to optimise treatment for individual clients. In addition, Jay has become an integral part of health promotion by PHU and organised specific events such as World Diabetes Day. Cathy Malla SECTION MANAGER In a relatively short space of time, Jay has filled a critical space in health care for Anyinginyi clients, in terms of preventing/reducing the high 2012/2013 ANYINGINYI ANNUAL REPORT • KALPA PURRU WIRRANGJARLKI/PUBLIC HEALTH UNIT REPORT 37 Annual Report 2012/13 Kalpa purru Wirranjarlki rates of diabetes and thus kidney disease in Barkly. She has also established some important links between AHAC sections, notably the Health Centre, Piliyintinji-Ki and the Regional Remote Health Service nutritionist, and also external service-providers. Indigenous Outreach Worker - Chronic Disease Lorraine Ward-Lewis started work with PHU in 2013, and has quickly established herself as a key liaison with the community. She works particularly with the Diabetes Educator to assist with the development of the program for the local community, and also gives practical assistance to clients needing to access health care and education in other areas. Lorraine’s role is pivotal in supporting clients to access relevant health care and education, and also in assisting PHU services develop and meet the needs of community stakeholders. Youth Health Worker This role initially developed from Leonie Williams’ strong skills in the area of youth engagement and education. Crossing the various areas of health promotion/education, Leonie worked initially with the FASD Project, then extended that to all the different programs, as required. She also engaged youth through other community-based services/agencies, such as the schools, the youth hostel and other youth networks. Youth are obviously the future, and the age group 15-25 years is an ideal time to assist and guide young people into forming good habits and increasing their health literacy. PUBLIC HEALTH UNIT This is the age when young people are about to start families of their own, and with increasing evidence suggesting the importance of the health of babies even whilst they are still in the womb in terms of longer term adult health outcomes, it is important to arm young people with as much health information and access to health and other services as possible. From mid-2013, PHU has recently welcomed Tyler Horwood into this role of Youth Health Worker, bringing with him a wealth of experience from Sport and Recreation, as well as some great new ideas. Administration This is always a vital area for PHU, and in addition to long-term administration officer, Louise Hanson, PHU now has the services of the very experienced, Sue Gates, who is situated in the Allied Health building. Louise continues her studies in Health/Community Care, and works part-time across different PHU areas. Program, plus the sharing of the Allied Health building with Regional Remote Services such as dentist, podiatrist and physiotherapist, drivers for community members with disabilities and chronic disease issues provide an essential service. Bevan Stokes and Billy Ah Kit continue to fill this valuable and expanding role. Conclusion The Public Health Unit has undergone many changes through the year, with programs multiplying and expanding, resources being developed, and staff moving through and between programs. The year culminated in the departure of Section Manager, Cathy Malla, on maternity leave for six months, and our best wishes go with her, Dinesh and Shanti for a happy, family time over the next few months. Adele Gibson will act as Section Manager until December, 2013. Drivers The PHU drivers are a special link between services and the community. With the regular Eye Clinics flourishing, the new Diabetes 2012/2013 ANYINGINYI ANNUAL REPORT • KALPA PURRU WIRRANGJARLKI/PUBLIC HEALTH UNIT REPORT 39 Annual Report 2012/13 Piliyintinji-Ki Piliyintinji-Ki/Stronger Families (PSF) provides culturally appropriate services for men, women and families of Tennant Creek and the surrounding Barkly Region. Piliyintinji-Ki is Warumungu for “to make something better, to cure or make something good.” Piliyintinji-Ki is not only the name of the section but also determines how we provide services to our people. Piliyintinji-Ki services have a holistic approach. Their delivery has included promotion and prevention initiatives that are fundamental to improving Aboriginal physical, social and emotional health status. Main Achievements • A Successful Drug Action Week. The whole week had a range of activities from several service providers. Some of the activities included: Women’s Footy match between Ali Curung and Stronger Sisters, separate Men’s and Women’s Camps, daily activities at Peko Park for interaction with community members and was completed with a family movie night. • Greater assistance to families and individuals. A Capacity Building Timetable has been developed for families and individuals to provide support for Nutrition, Family Violence, Bush Medicines/Tucker, Cultural outings (healing), Specialist Education Sessions (eg: diabetes or foetal alcohol spectrum disorder, sewing, visitng specialist and services) and outreach services (eg: housing, hospital, babies, Centrelink etc). • Staff completion of courses. Patty O’Donoghue completed Cert IV Community Services Work and Cert IV Youth, Children and Family Intervention, Deb Fry completed Cert IV Community Services Work, Pamela Clarke completed Cert IV Business. • Implementation of Intensive Family Support Services. The establishment of the IFSS program has been completed. This program assists children at risk and/or neglect and aged between 0-12 years old. The program is flexible to client need and can include home visits, work on-site at PiliyintinjiKi in collaboration with the Men’s and Women’s Centre, and support with accessing other AHAC services including the Clinic, Public Health and Allied Health Services such as nutrition, smoking and hygiene etc. To date there have been sixteen families referred to this program. We have successfully attained a Coordinator/Counsellor, a full time counsellor and male and female Community Support Workers. • Funding for relocation of Piliyintinji-Ki. Funding has been provided for major renovations at the Regional and Remote Health Services on Patterson Street (next door to Mobil). A huge thank you to the Department of Health and Ageing (DoHA) and Family and STRONGER FAMILIES Piliyintinji-Ki services have a holistic approach. Their delivery has included promotion and prevention initiatives that are fundamental to improving Aboriginal physical, social and emotional health status. Housing Community Services and Indigenous Affairs (FaHCSIA). Piliyintinji-Ki are due to move into the newly renovated buildings in September/October 2013. Without their generous contributions, this would not have been possible. Minor Achievements • White Ribbon Day. The Men’s Centre facilitated this event and was led by the young males in the Clontarf Academy. The Oath was translated in Warumungu language. • National Apology & Sorry Days. These two events were facilitated by the Women’s Centre and held at Peko Park and there were a number of older generation members in attendance. The land mark Parliamentary announcement “recognising Aboriginal and Torres Strait Islander peoples as the first nations peoples” Joyce Measures Numakili SECTION MANAGER 2012/2013 ANYINGINYI ANNUAL REPORT • PILIYINTINJI-KI/STRONGER FAMILIES REPORT 41 SPORT & RECREATION Community Support Physical activity is a key component in the prevention of Chronic disease. At Anyinginyi Sport and Recreation the staff are getting the community active. In years gone by it could be easy to think that Sport and Recreation was for kids and gym junkies but that concept has been shelved with the amazing programs and activities that have been run out in 2012/2013. The centre has seen a 60% rise in patrons entering the venue, the staff have lifted the quality of programs being delivered. Some of these programs include circuit training, cross fit style exercise, boxercise, MMA with local policeman Des Green who has been an asset to the centre running classes for free and taking his team up to represent Tennant Creek in Darwin and Alice Springs, Des is a role model for the force and does a great job linking with Sport and Recreation and the young people of Tennant Creek. The current staff include the extremely organised and reliable Tanya Jones, Nicholas Foster, Tyson George, Gary Marshall, Cornelius Power who is studying his Certificate III in fitness and doing an amazing job, Jameson Casson, Tyler Horwood who is now also been promoted to the Public Health Unit. Jameson Casson is one of the staff members who has grown through his employment through Sport and Recreation: The following is an article based on Jameson’s story. For Jameson Casson, helping his community comes naturally. The 27 year old from Tennant Creek has donated countless hours of his time collecting cans and bottles around Tennant Creek to raise funds for new sporting equipment for youth in his community. Passionate about sport, Jameson volunteered his spare time to helping out at the Anyinginyi gymnasium, run by the Anyinginyi Health Aboriginal Corporation’s Sports and Recreation Unit, before becoming an employee in 2012. It’s a big achievement for Jameson, considering he has a disability that would normally create barriers to employment. Sport and Recreation Manager, Adam Drake, said his organisation took the initiative to employ Jameson after they got to know him and saw his wonderful qualities. “If you recognise and nurture people’s strengths you get the most out of them,” says Adam. “We could see early on that Jameson’s helpful nature and genuine interest in the people around him would be a great asset.” Jameson was employed to work with children and young people on sporting activities, including an after-school program, which sees 80 to 100 kids each afternoon playing structured games such as basketball, dodge ball, cricket and T-ball. “In some ways Jameson’s simple way of thinking is one of his greatest strengths because he doesn’t overcomplicate things,” says Adam. Wirlyarra punjarlki kapi Miripartijiki “He doesn’t have boundaries to how he thinks and he doesn’t let personal issues or inhibitions get in the way. He just gets out there and does it.” team. Jemma is an asset to the organisation and to her family. Adam says his organisation has set a good example of what can be achieved by giving people a chance. “This has definitely raised awareness amongst our community of the importance of giving people a chance to shine, and just how positive the outcomes can be.” Jameson’s interest in his community has not gone unnoticed. On Australia Day this year he was awarded The Tennant Creek Australian of The Year Junior Award for his contributions. More recently, he won the Puggy Hunter Award for his volunteering efforts at the Stronger Futures Alice 3on3, which was attended by a range of Indigenous celebrities, such as Jacinta Price and Luke Carroll, who helped promote youth leadership and the importance of getting a good education. In addition to the excitement of rubbing shoulders with the celebrities, Jameson says he was proud to receive an award for helping out. “I was proud that I could tell my family and friends in Tennant Creek about this achievement. I want to be good example and role model for the young ones and the old ones in this community,” says Jameson. Jemma Patterson also has an excellent story. Jemma was our first full graduate from Tennant Creek High School and is now enrolled in a Certificate IV in Population Health. Jemma has also moved through the ranks as a junior staff member to a senior staff member and now she has moved to the Public Health Unit working as a healthy lifestyle worker with the anti tobacco The Sport and Recreation building has had major upgrades with cardio room and kids room receiving air conditioning, the kitchen has been refurbished for the Friday Night Games cooking and healthy cooking programs. Work is about to start on the air conditioning of the complete gym area. Tennant Creek will be enjoying these facilities in the near distant future. Many other great events have occurred at Sport and Recreation including Dive into Life (water event for youth week), Friday Night Games, Move it Mob Style joint with Barkly Regional Arts, Afterschool Program and School Holiday Program, Rossy Williams Shield, Volleyball, Mixed Volleyball, Indoor Soccer, Netball and many other great programs. Adam Drake SECTION MANAGER 2012/2013 ANYINGINYI ANNUAL REPORT • WIRLYARRA PUNJARLKI KAPI MIRIPARTIJIKI/SPORT & RECREATION REPORT 43 Annual Report 2012/13 Manu Kinapina Parlpurru Ninji Kari The Regional Remote Health Section (RRHS) provides Primary Health Care Services to smaller communities and outstations outside of the township of Tennant Creek within the Barkly Shire which are not serviced by the Northern Territory Department of Health. Providing health services to remote communities provides many challenges. These include poor road conditions especially during the wet season; extremes of temperature; the absence of suitable facilities to work out of in communities; a client base that is very mobile; long days; and many logistical issues related to getting the “show on the road” to begin with. We are fortunate to have staff who are dedicated to improving the health of our community and who happily confront these challenges on a daily basis in order to provide the service in the most efficient and effective way that they can. As an Aboriginal Community Controlled Health Service we are well placed to meet the needs and expectations of the local community because of the close relationship that we build with our clients while on their journey to better health. The dedicated team at RRHS comprises: • A receptionist who is the first point of contact for visitors and provides valuable support to all other team members • A clinical team comprising Doctors and Registered Nurses who provide the Primary Health Care services • An Allied Health Team which includes a full-time nutritionist and a visiting (locum) Physiotherapist, Podiatrist, Dentist and Dental Assistant • A Grow Well Co-ordinator, who runs support programs for young children and their mother’s/carers in remote communities • A section manager who is responsible for the day to day operations of the unit REGIONAL REMOTE HEALTH SECTION A Snapshot of Services Provided by Regional Remote Health Section CLINICAL SERVICES • The Clinical team (Doctors and Nurses) visit approximately 16 communities in total in the Barkly Shire, however these communities are not always populated, depending on the season and cultural obligations. Many of the small outstations may only be populated for short periods during the year. There are 11 communities however that receive a regular weekly or fortnightly visit. Some of these communities are a short 15 minute drive whilst others can be 1 to 4 hours’ drive away. • There is a considerable amount of preparation to be done before departing on a community visit so that the team has all the resources that they need at hand. Laptops are synchronized for up to date client information; clients needing more immediate attention are identified in advance; medical supplies and equipment are checked and packed safely and securely in the vehicles; safety check; and communities are contacted to advise them of the expected arrival time of the team. On return to base the vehicles are unpacked and preparations made for the next day out. • Due to the mobility of our client base it is very easy for individual members of the community to miss out on appointments with the clinical team however a concerted effort by the team to keep track of people movements and maintain a continuum of care has reduced the number of outstanding health recalls in the past 12 months. A significant effort has also focused on getting clients to have their annual health checks completed and in moving chronic disease patients on to GP Management Plans, which again assist in improving the level of care to the client. ALLIED HEALTH SERVICES Allied Health Professionals work in partnership with the Clinical teams through a referral system. The Allied Health services provided in Tennant Creek by AHAC include: NUTRITION Good nutrition or eating habits are the cornerstone of good health. Many health problems can be linked back to poor eating habits over long periods of time, especially when we are young. In our community poor eating habits are not the only issue. Many people have problems around food security. According to the World Health Organisation food security is built on three pillars: • Food availability: sufficient quantities of food available on a consistent basis • Food access: having sufficient resources to obtain appropriate foods for a nutritious diet • Food use: appropriate use based on knowledge of basic nutrition and care, as well as adequate water and sanitation. In our communities we have to add cultural obligations because often when family members visit unexpectedly the food has to stretch a lot further. The Nutritionist works closely with individuals and groups within the community to look at how these issues can be resolved, with an emphasis on education and capacity building. PHYSIOTHERAPY Many individuals’ lives are impacted on by mobility issues, due to injury, long term illness or ageing. A Physiotherapist can assess the 2012/2013 ANYINGINYI ANNUAL REPORT • MANU KINAPINA PARLPURRU NINJI KARI/RR HEALTH SECTION REPORT 45 Annual Report 2012/13 Manu Kinapina Parlpurru Ninji Kari physical condition of patients to diagnose problems; use a range of techniques to strengthen and stretch muscles and joints to improve patient mobility; and educate patients, their families and the community to prevent injury and disability and to lead healthy lifestyles (to name just a few). The Physiotherapist at AHAC works out of the Allied Health Building on Irvine Street. Her services are on a locum basis i.e. she visits for a few weeks several times per year. The therapies that she employs are well received by the community and her visits are always fully booked out, which is a testimony to the work that she does. PODIATRY The prevention, diagnosis, treatment and rehabilitation of medical and surgical conditions of the feet and lower limbs. This is particularly significant in the Barkly Region where many conditions may be a result of chronic disease (especially renal disease and diabetes) and the Podiatrist works closely with the Tennant Creek Hospital Renal Unit, HAC Services and Pulka Pulkka Kari (Nursing Home) in Tennant Creek. The Podiatrist too works out of the Allied Health building on Irvine Street and like the Physiotherapist his services are provided on a locum basis throughout the year. Our current Podiatrist has also made an excellent name for himself over the past 12 months and his time in the community is well utilized. DENTAL HEALTH This refers to all aspects of the health and functioning of our mouth especially the teeth and gums. Apart from working properly to enable us to eat, speak, laugh (look nice), our teeth and gums should be free from infection, which can cause dental caries, inflammation of gums, tooth loss and bad breath. The health of our teeth and mouth are linked to overall health and well-being in a number of ways. The ability to chew and swallow our food is essential for obtaining the nutrients we need for good health. Poor dental health can also adversely affect speech and self-esteem. Dental diseases impose both financial and social burdens as treatment is costly and both children and adults may miss time from school or work because of dental pain. The dentists employed by AHAC work in the Allied Health Building in Irvine Street. We are currently operating with locum dentists however we have been successful in maintaining a steady service with very experienced and highly professional practitioners. THE GROW WELL PROGRAM The Grow Well Program was implemented to provide families in our community with education and resources focussed on raising happy, healthy children. It is delivered to a number of remote communities and in Tennant Creek. REGIONAL REMOTE HEALTH SECTION their children, therefore we have been able to redirect our resources to those who are in the greatest need. Families in our remote communities face many challenges which can The outreach services provided by the Regional Remote Health Section of AHAC play a significant role in the lives of people in the remote communities. Unlike the coastal regions of Australia there are no local transport services and not all families have access to a motor vehicle. The cost of fuel to run a vehicle (when one is available) to larger towns like Tennant Creek, to get to health services puts pressure on already overstretched finances. to provide for their children and give them the best start in life. The early childhood years are very important for their growth and development and as such the Grow Well Program is designed to address the needs of the 0 to 5 year olds and those who care for them. Initially the program focused on capacity building activities around nutrition, hygiene, health and understanding the importance of early childhood developmental needs. However, this year we have been able to shift our focus more on individual families/children in need. This has been a result of a review of the situation “on the ground” in communities. Some of our communities previously serviced have seen improvements in the health status of What is generally not considered when it comes to the value of these services is the “human” aspect i.e. the comfort and feeling of support that the client receives from knowing someone cares and will be there each week to provide that much needed health care. Allan Baldock SECTION MANAGER 2012/2013 ANYINGINYI ANNUAL REPORT • MANU KINAPINA PARLPURRU NINJI KARI/RR HEALTH SECTION REPORT 47 Annual Report 2012/13 General Purpose Financial Statements FOR THE YEAR ENDED 30 JUNE 2013 2012/2013 ANYINGINYI ANNUAL REPORT • FINANCIAL STATEMENTS 51 Income Statement For The Year Ended 30 June 2013 2013 $ 2012 $ 12,839,740 10,471,640 Revenue from rendering of services 908,860 572,094 Interest 328,376 412,981 1,085,876 760,447 15,162,843 12,217,162 [7,271,470] [5,027,678] [796,758] [823,650] 93,903 [74,393] Depreciation expense [945,833] [884,678] Loss on sale of assets [37,301] [206] [3,831,684] [3,659,804] [12,789,143] [10,470,409] 2,373,700 1,746,753 Income Government Grants Other revenue from ordinary activities Total Revenue Expenses Employee salaries & wages Employee oncosts Employee leave expense (provisions) Other expenses from ordinary operating activities Total Expenses Surplus/(Deficit) From Activities Statement Of Comprehensive Income For The Year Ended 30 June 2012 Surplus/(deficit) for the year Other comprehensive income Total Comprehensive Income/(Deficit) For The Year 2,373,700 1,746,753 - - 2,373,700 1,746,753 2012/2013 ANYINGINYI ANNUAL REPORT • SECTION TITLE 53 Statement Of Financial Position At 30 June 2013 2013 $ 2012 $ 9,142,717 9,453,965 125,872 23,322 9,268,589 9,477,287 8,172,657 8,277,488 17,441,246 17,754,775 1,359,602 1,529,079 10,563 18,320 527,539 602,054 1,263,841 3,699,321 3,161,545 5,848,774 - - 3,161,545 5,848,774 14,279,701 11,906,001 Current Assets Cash and cash equivalents Trade and other receivables Non Current Assets Property plant and equipment Total Assets Current Liabilities Trade and other payables Borrowings Provision for employee entitlements Unexpected grants Non Current Liabilities Provision for employee entitlements Total Liabilities Net Assets Statement Of Changes In Equity For The Year Ended 30 June 2013 Accumulated funds at start of year Total comprehensive income (deficit) for year Accumulated Funds At End Of Year 11,906,001 10,159,248 2,373,700 1,746,753 14,279,701 11,906,001 Statement Of Cash Flows For The Year Ended 30 June 2013 2013 $ 2012 $ Cash Flows From Operating Activities Payments Employee costs [7,949,382] [5,936,550] Materials, contracts and other costs [4,083,926] [3,035,470] 1,875,484 1,786,220 10,404,260 10,591,985 246,436 3,406,185 328,376 412,981 [909,926] [2,196,321] 31,624 500 [549,926] [1,782,840] - - 303,490 1,623,345 9,435,645 7,812,300 9,132,155 9,435,645 Receipts from activities Recurrent grants Net Cash Provided (Used) By Operating Activities Cash Flows From Investing Activities Interest received Payments for property, plant and equipment Proceeds on sale of assets Net Cash Used In Investing Activities Cash Flows From Financing Activities Net cash provided (used) by financing activities Net increase (decrease) in cash held Cash at beginning of the year Cash At End Of The Year 2012/2013 ANYINGINYI ANNUAL REPORT • SECTION TITLE 55 My Story The Way I Lived The way I lived in my younger days, I was brought up through many ways, Culturally, Traditional, Spiritually and Emotional, Happy and full of laughter, Singing, dancing and walking around everywhere in the bush, With my relatives and family and with the elderly people, They were around me a lot of the times teaching me about Culture and Tradition and other Spiritual things, That was the way I used to live in my younger days, All through my childhood and towards my adult age, But that has all changed now in this day and age, Those special moments have all gone now, But it will be kept within my soul and my heart for ever, Those days were the good times and how I lived, Now there are times of quietness and stillness lingering around me, There is no fluttering of the leaves on the tree because of the silence and stillness of the days, Not a breeze in the air everything is so still, Not like my younger days of growing up with the elders and their stories, Some of the Culture and Stories may one day not exist because of the younger generation who are to busy drinking and gambling and doing drugs. Written by Winnijipurrtu Nixon Anyinginyi Health Aboriginal Corporation 1 Irvine St, Tennant Creek, NT, 0860 PO Box 403, Tennant Creek, NT, 0860 T. (08) 8962 2633 F. (08) 8962 3280 www.anyinginyi.org.au