Alison Williams
Aboriginal Health Worker, Gudbinji, Wurli-Wurlinjang Aboriginal Health Service, Katherine, NT
How did you come to be an Aboriginal HealthWorker?
I have been working at Wurli-Wurlinjang Aboriginal Health Service since 2006. My mother’s people are Kalkadoon from near Mt Isa and my father’s people are MalantjiI from Beaudesert in Queensland. I moved from Queensland to Katherine to be near my sister, and start a new life.
I was thirty-eight, and had just had my third child. I was working as a cleaner at a nearby hostel. My friend was an Aboriginal Health Worker. She encouraged me to apply for a traineeship- saying I could make a difference and improve my life too. I was lucky as I was able to take my baby to training, and could also take him to Batchelor Institute where they had daycare for children. I worked at the main clinic for a year after I graduated. Then I moved to Gudbinji- the chronic illness clinic- I’ve been here ever since. My main area of expertise is rheumatic heart disease, although we all learn from one another about the different health conditions we see.
What are the main health issues you see at Gudbinji?
Our focus is chronic disease. We have clients with diabetes, renal disease, asthma, and heart disease. We have a few clients who have had kidney transplants and many who are receiving dialysis.
What does your work involve at Gudbinji?
The Aboriginal Health Workers prepare the clients for seeing the doctors. We see everyone first, and if we can deal with, then we do. We give immunisations, take blood and do a lot of education about self-management and prevention of complications. We set up for the health promotion and self-management days, and assist with adult health checks and care plans. The CARPA manual is our bible.
We have aged care days on Mondays and Tuesdays, heart days are on Tuesdays too. Wednesday is exercise classes and in house training. Thursday is diabetes day. We also provide palliative care when needed. The team includes two Aboriginal Health Workers, two nurses, a renal coordinator and diabetes educator, the Community Liaison Officer and transport worker, and our receptionist. There is also always a doctor in the clinic.
Basically we identify what the mob lack and try to meet those needs. For example, we assist those people living in the long grass- as we call them, the “Long Grassers”. We offer them showers, a healthy cooked breakfast, we look after their tablets for them and let them watch movies in the Centre. Left-over food is parceled up and offered to people in the parks. We have a Community Liaison Officer who also provides transport. He goes with us to the four communities on the edge of town and reaches out to people in the communities.
What do you enjoy about the work?
We have permanent staff here and the workers are consistent. We have a good supportive team. I enjoy making a difference to the Indigenous mob, building bonds to form a trusting therapeutic relationship which encourages them to come in for help. Although the clients may forget what you say they never forget what you do. Personally I am pleased to be working here, it allows me to support my kids on my own.
What about the challenges?
There are language barriers. I have learnt some of the local words which helps. Housing is a problem in Katherine. We also have to chase up people to provide follow up. You have to be like a detective to track people down and find out where they are living.
What is a memorable event?
We are making a difference to people’s lives with our education and treatment. We build a trusting relationship and educate our clients to look after themselves. We see people reduce their sugar levels and lose weight.
Sometimes the work is hard. We supported a young man with rheumatic heart fever. He became like a family member. We saw him every day and he had a lot of hospital admissions. Sadly, he died when he was only twenty-three. The Gudbinji staff were invited to his funeral and asked to speak.
Dr Ahmed Latif
Public Health Physician, Medical Director, Sunrise Health Service, Katherine, NT
I started work at Sunrise in 2009. My medical career started in Zimbabwe where I eventually became the Dean of the Faculty of Medicine. My areas of expertise are public health, chronic conditions and, in particular, infectious diseases such as HIV and other sexually transmitted infections. This interest led to the development of the syndromic approach for the management of sexually transmitted infections. I have worked for the World Health Organization as a consultant and I have worked in most of the WHO Regional Offices in including the WHO Headquarters in Geneva, Switzerland where I lived for 18 months. In our region I have worked as a consultant for the Western Pacific Region with the World Health Organization. My work in WHO has taken me to over 60 countries in the world where I was engaged in developing training materials, developing strategic plans and conducting training and research. I also worked for CDC in Alice Springs in the Tristate STI and BBV Program for three years.
What does your work involve at Sunrise Health Service?
Sunrise Health Services covers eight Aboriginal communities east of Katherine. As Medical Director I oversee all the health services including the acute, chronic and preventive health services. I have a key role in gathering information, data analysis and report writing. For example, we have recently produced the Chronic Conditions Report Card that outlines the main chronic conditions in all our communities. I conduct regular clinical audits; we have developed our own audit tools known as the Sunrise Essential Clinical Audit (SECA) tools. We conduct public health initiatives and health education programs such as Be Healthy: Stay Strong, and the Healthy Homes project. “Shelf talkers” are a recent health promotion initiative – cardboard posters with pictures and brief spoken messages (you press a button to hear the message in English and Kriol) about healthy food choices. These are put in the community stores.
What are the main health issues?
The main health issues include diabetes, chronic kidney disease, asthma, hypertension, and hyperlipidaemia. Obesity, alcohol and smoking are all significant risk factors. We also see a lot of skin and ear infections. Dental health is of great concern. A large number of our health problems are related to the social determinants of health and if these are addressed I am sure we will be to make a difference to the health status of our community members.
What do you enjoy about the work?
I enjoy working with some very committed people. I have seen some improvements over the years with our service delivery. We have a better understanding of disease prevalence and effective interventions. We also work more closely with the communities and involve the members in the planning and development of the programs. Personally I like living in Katherine, it is centrally located and friendly.
What about the challenges?
Workwise it is a challenge to change lifestyle and behaviours. I also believe one of the biggest problems here is lack of education. Many of the children don’t go to school. This is different from Africa where parents are desperate to get their children educated and save money to pay for schooling.
I am a long way from my own children who live in other states. I also have extended family in Zimbabwe and only manage to visit them every five years or so.
What is a memorable event?
Sunrise has produced its own health promotion DVD, the Public Health Intervention DVD. We are distributing it widely in the communities. It uses local people to spread healthy messages to the public. Health promotion is an important part of our work here.
Rosie Gudonis
Registered Nurse, Areyonga NT
I currently work in the Aboriginal community of Areyonga, 224 kilometres west of Alice Springs. It has a population of about 300. Most of my nursing experience has been in rural and remote Queensland. I have worked at Charters Towers, Ingham, Hughenden, Mornington and, more recently, Palm Island.
What did your work involve on Palm Island?
On Palm Island I worked in the ward (10 beds) and in the Emergency Department. My work involved team leader duties and general nursing duties including assessments, suturing, cannulation, backslabbing, and preparing patients for evacuation. I liased closely with the Medical Officer and allied health workers. Where possible, I also did opportunistic health checks and health education of patients. The main health issues were chronic diseases such as diabetes, renal disease and cardiac disease. We also saw alcohol related events and issues. Medication non-compliance led to ongoing health and treatment challenges.
What do you enjoy about the work?
I love Palm Island and the work environment there. I enjoy working in a community-both in the community at large and in the nursing fraternity. The challenges I face extend my scope of practice and I learn something new each day. I have the opportunity to work with, and learn from, some wonderful experienced and knowledgable colleagues. I also enjoy the cultural exchange.
What about the challenges?
It is a challenge coming to the realisation that change is often very slow and almost imperceptible. We try to make a difference and can fall short due to our lack of understanding of the cultural issues at large. At times we may not feel validated for all the work that we do, and it can be very tiring.
What is a memorable event?
I remember a junior nurse and myself were to work five night shifts and were worried about how we would cope….I think we used every page of the PCCM (Primary Clinical Care Manual, put out by the Royal Flying Doctor Service and Queensland Health). If you came in with a sore toe we did an ECG, sutured anything hanging about, did a sexual health screen and may have looked at your toe! It was a huge learning curve for us but we survived and so did our patients!
Lee Oliver
Rural and Remote Area Nurse, Marla, South Australia
What does your work involve?
There are two nurses based at the Marla Health Clinic. We’re it, most of the time. We also double up as ambulance officers. Trauma is quite common up here as Marla is on the Stuart Highway and we get road accidents. We also often play a role in stabilising patients from the APY (Anangu Pitjantjatjara Yankunytjatjara) Lands. Other key health issues here are diabetes and cardiac disease. Diet is often poor and access to fresh food is challenging. We work week on and week off. We are on-call 24 hours during one week, and then we rest the following week. We can go away during this rest week; if we stay around we will provide back up for our colleague. There are no permanent doctors here. Doctors visit twice a month, we also have other allied health professionals visiting with the Royal Flying Doctor Service team. We organise these visiting clinics. A teleconference screen is also available for consultations with specialists. We probably service a population of about 200 people including the populations of Marla, Mintabie and the surrounding stations.
How long have you been working at Marla?
I’ve been working at Marla for six weeks. I am currently doing agency work in rural and remote Australia. The clinic covers up to the Northern Territory border and half way to Coober Pedy. I’ve been a registered nurse for 38 years, and have always done rural or remote work.
What do you enjoy about the work?
Remote nursing is a very rewarding job. It is challenging as you never know what you’re going to get. It calls for critical thinking and the use of all your nursing skills …and more, such as pharmacy, gardening and bush mechanics! I enjoy travelling, and can work as I travel. There are also opportunities for professional development, although you often need to travel.
What about the challenges?
It can be isolating work. I miss my family, however my daughter and her family are with me in Marla for a while which is great. Shopping is expensive. Being in the desert means there are long distances to travel to get anywhere. I rent out my home near Townsville whilst I travel and work.
Can you tell us about a memorable incident?
Just last week there was a motor bike accident on the Stuart Highway. A father and son were on a road trip from WA to Darwin. It was late afternoon, the sun was low, and the father’s bike hit the gravel by the side of the road and he came off. A Road Train driver picked him up and took him to the local police station. I collected him and we had him in the clinic for 20 hours whilst we waited for the Royal Flying Doctor Service (RFDS). There were five Category One critical cases waiting for the RFDS at the time. The man had a compound fracture of his arm, a broken shoulder and multiple abrasions. We cared for him and administered pain relief and antibiotics before he was retrieved.
Gwenda Lawton
Clinical Coordinator/ Registered Aboriginal Health Worker, Wurli-Wurlinjang Aboriginal Health Service, Katherine, NT
I hold the position of Clinical Coordinator at Wurli-Wurlinjang Health Service – an Aboriginal Community Controlled Health Service in Katherine in the Northern Territory. The Health Service became independent in 1991 with an Aboriginal Board of Management. I am originally from Mitchell in Queensland, I came to the NT from Cunnamulla Queensland in 1975, however all of my health work has been in the Territory. I am a Registered Aboriginal Health Worker.
In 1986 I was a cleaner at Anyinginyi Health, Tennant Creek when the Director asked me to become a trainee Aboriginal Health Worker. I started my training in 1987 and 25 years later I am still working in Aboriginal Health. My involvements started with Wurli-Wurlinjang in 1992 when I gained employment as a Senior Aboriginal Health Worker (AHW).
What does your work involve at Wurli-Wurinjang Health Service?
In 2000 I became the Clinical Coordinator. I work in middle management supervising six AHWs. Mentoring the AHWs and helping to build their skills is important. Our team works closely with the doctors. All patients see an AHW first and then a doctor if needed. I do a lot of administrative work overseeing the clinic, however I can fill in clinically if we are short staffed. I particularly enjoy working in women’s and children’s health. I order the dry stores and medical supplies, and maintain the medical equipment. We try and keep the clinic in good order so every worker contributes to house keeping. I believe in communication; family values; teamwork; and showing respect for everyone.
What do you enjoy about the work?
I enjoy working in an Aboriginal Health Service. We all have a right to have a say. We get to use all our skills and you feel like a member of the health service family. It is important to have Aboriginal Health Workers here, it makes people feel comfortable coming to the Centre. They have a sense of belonging. We treat people as humans not as numbers. We need Aboriginal Health Workers to close the gap. They act as brokers between the patient and the doctor.
I prefer living in the country, and Katherine has all I need- for example, it has a cinema and we now have a new Cultural Centre, where shows can be held. I enjoy the entertainment that comes to town and it gives us somewhere else to go.
What about the challenges?
There are still not enough Health Workers and until recently, we were underpaid. This has improved now. Personally, the build up to the wet season can be hard, and it gets harder as I grow older. Every now and then I return home to Queensland to see my mob- but I am always happy to come back to Katherine.
What is a memorable event?
A highlight for me was in 2007 when I won the Northern Territory Aboriginal Health Worker of the Year. It felt good to be recognised for my work. I also gave a presentation at the National Aboriginal and Torres Strait Islander Health Worker Association AGM in 2012 and was honoured with their inaugural Legend award. I still enjoy my work providing health care to our people. I believe we all need to have access to good health care and also take responsi
bility for our own health.
Albert Watego
Trainee Aboriginal Health Worker, Wurli-Wurlinjang Aboriginal Health Service, Katherine, Northern Territory
How did you come to be an Aboriginal Health Worker?
I was one of fourteen children- the second eldest son. We grew up in Ayr in Queensland.
I started work at the age of thirteen, during the school holidays, cutting sugar cane. My mother’s people are Kanak , brought to Queensland to work on the sugar cane plantations. I left school at fifteen and worked as a labourer. As the second eldest, I was needed to help bring in money for my family. My father was a hard working truck driver for much of his life. He had a strong work ethic that he passed on to his children. I came to Katherine over twenty years ago to help build the airbase at Tindal.
In my early fifties I realised I was sick of going to the funerals of my Indigenous friends- people I had grown up with. I decided I wanted to get in there to help fix the problem. I had noticed a regular advertisement for trainee Aboriginal Health Worker positions at Wurli-Wurlinjang over the years, and given it some thought in the past. I decided to apply. I’m now in my second year of training. We have great support here at the Centre for our training.
What does your work involve at Wurli-Wurlinjang Health Service?
The Aboriginal Health Workers screen all patients that come in to Wurli. We see them and then, if needed, they see the Doctor. My training involves theory training with Leanne the RN, on-the-job training in the clinic, and two week blocks at Batchelor Institute. I am keen to learn the medical side of things, and the Senior Health Workers and Doctors play a central role in my on-the-job training. We use the CARPA manual for guidance.
What do you enjoy about the work?
I enjoy the work here. The Centre is like a well-oiled machine. There is a good work ethic; it is a very professional place. We work together well as a team and are all on the same page. It is also a friendly place to work.
What about the challenges?
My main challenge is learning about the computers and the programs we use in the Centre. I can always ask if I need help though!
What is a memorable event?
A young fella came in with a bad leg ulcer. He had run away from his wife and new baby, and was camping out in the long grass with his friends drinking. He came in a few times, and the wound was not getting better. It was dirty and he had poor hygiene. I showed him some crutches in the corner of the room, and told him he could lose his foot and be using them long term if he didn’t start looking after himself. He gave up drinking, smoking and returned to his wife.
Dorothy Butler
Eye Health Coordinator, Registered Aboriginal Health Worker – Wurli-Wurlinjang Aboriginal Health Service (WWHS)
I am a Jawoyn woman, Katherine is my home. When I was 18, with encouragement from my mother, I joined the Australian Army and trained as a nurse. After three years in the army, I started work at Katherine Hospital as an enrolled nurse and worked there for
31 years. In the last 3 years of my hospital career I held an eye health position.
We flew to remote communities in the Top End- as far as Darwin, Gove, and the Tiwi islands such as Melville Island and Bathurst Island. There was a team of us that travelled-an ophthalmologist, a doctor, a registered nurse and me. My training in eye health was done by those wonderful doctors and nurse. Ten years ago the position of Regional Eye Health Coordinator was introduce to WWHS. They required an Aboriginal Health Worker so I completed the relevant training to become a Registered Aboriginal Health Worker. I worked for ten years travelling to remote communities by road in the Katherine district. The wet and dry season govern when and where you can travel.
I was motivated to get into health care as my mother was a chef at the hospital and I saw the kind of work that was being done. I also became aware that my people were not receiving proper eye care. Aboriginal Health Work is a good career, and can be a stepping stone to further your career if you desire…
What does your current work involve?
My job is to screen all clients registered at Wurli-Wurlinjang Health Centre who have eye problems, especially all diabetics. Part of the screening is to take retinal photographs to check for any changes and problems with diabetes. I also coordinate Ophthalmologist and Optometrist visits, and provide the necessary administrative support. This also includes a referral pathway to other medical services and hospitals. Another important part is to organize transport and spectacles. WWHS supports the Fred Hollows Foundation Low Cost Spectacles Scheme.
The main eye health problems I see are refractive error, diabetic retinopathy, cataracts, eye trauma and occasionally trachoma or the effects of trachoma, such as scarring.
I screen all the Indigenous children’s eyes once a year at the local 5 Primary Schools and 2 High Schools. On an average we see 500 students per year .We screen all students once a year for trachoma, vision distance and near and colour vision every 2 years or when required. So far this year we have not had any children with trachoma. Trachoma is not usually in the communities with plenty of water or a swimming pool. It is more of a problem in the dry areas. We educate the children about eye care and hygiene- for example, clean faces, clean hands and blowing their noses.
What do you enjoy about the work?
I can see the changes that have occurred – the improvements in eye care. People can get glasses more easily now. I enjoy the company of the other staff members at the Health Centre, we are like a family.
What about the challenges?
It is difficult when people don’t come to their appointments, and we miss screening some of the diabetic patients. Sometimes we don’t get feedback from the specialists at the hospitals when we make a referral- it can be hard to know whether people have been seen or what was the outcome of the referral.
What is a memorable event?
I learnt that if you show respect to people, then you get respect.
I recall going to a remote community that took six hours travel. After I set up the clinic, two old, well dressed men came in. They introduced themselves; I looked at my list and couldn’t find their names. I apologized by saying “Sorry, your names are not on the list”. They replied “We know, my girl, we just came in to say hello”. They were keen to introduce themselves and check out who was coming in to their community.