As we celebrate National Reconciliation Week in Australia, we look at the five steps that peak health bodies took to protect Aboriginal and Torres Strait Islander communities during the Covid-19 pandemic.
As Australia’s response to the Covid-19 pandemic shifts from crisis to recovery mode, the lessons learned from the 2009 swine flu outbreak have kept the coronavirus infection rate among Indigenous peoples low and protected remote communities from outbreaks. One of those lessons was to act quickly and remain vigilant even as the crisis recedes.
“The real risk to Aboriginal and Torres Strait Islander communities is when restrictions are relaxed and remote communities are exposed to the virus from visitors” said Angela Young from the Queensland Aboriginal and Islander Health Council (QAIHC).
“The Aboriginal and Torres Strait Islander population is considered vulnerable because our people generally experience an earlier onset of chronic disease and are more likely to be impacted by the social determinants of health, such as inadequate housing, overcrowding, lower income and unemployment”
Over a decade ago, Aboriginal and Islander peoples were six times more likely to contract swine flu than the general population.
“What we learnt from swine flu is that Aboriginal and Torres Strait Islander peoples were adversely affected compared to the general population” Angela said.
Infection rates low among Indigenous Australians
The sector is monitoring the devastating experience of the Native American nation, the Navajo. The Navajo have a population approximately the size of the Indigenous people living in Queensland and half of Northern Territory combined, yet they have had about 4,000 positive cases and 140 deaths. In Australia, the infection rates among Indigenous peoples remain low, with only 59 cases across the country, less than 1 per cent of all people infected.
According to the Australian Institute of Health and Welfare’s Online Services Report, the Queensland Aboriginal and Torres Strait Islander health services have between 100,000 and 140,000 clients out of a total population of approximately 196,000 Aboriginal and Torres Strait Islander people. Remarkably, only nine Aboriginal and Torres Strait Islander people in Queensland have contracted the coronavirus, the majority of those cases in major cities.
“These numbers are incredible and can be accredited to the Aboriginal and Torres Strait Islander community-controlled health sector across the country and the self-determination of remote communities exercising their rights in demanding greater community protection,” Angela said.
The results were even better in Western Australia.
The Aboriginal Health Council of Western Australia (AHCWA), with its member services, is the largest network of primary health care providers across the state for Aboriginal and Torres Strait Islanders and yet has had no confirmed cases.
AHCWA chair Vicki O’Dowell cautioned a positive case in a community would “guarantee to have at least 15 to 20 contacts” because of crowded living arrangements. “It would be devastating,” she said.
Early response to protect communities
So what were the ingredients for such a strong outcome?
First, the swift response to end face-to-face consultation and negotiate critical supplies for medical staff and communities before the rest of the world swung into action.
“As a sector, we started looking at this virus in January,” Vicki said. “Some regions were ordering PPE because they predicted this would end up spreading nationally. They could see it was starting to spread across – even to the extent that our regions were already putting their remote nurses in 14 day isolation long before border security came in.”
Medical services swapped information
Second, the WA and Qld peak health bodies brought together its affiliates to share resources and information. “Where we did well was we were able to quickly adapt resources developed in one region to other regions,” Vicki said.
Effective health campaigns
Third, the community controlled health sector ran “dynamic public health awareness campaigns” with small budgets and shared resources with their state counterparts so that the response was nationally aligned.
They educated communities in a culturally appropriate way about the risks and the need for social distancing and good hygiene practices in radio ads, videos and health promotion material translated into local languages.
Funding for critical supplies
Fourth, funding for critical supplies when they ran short kept medical staff and communities safe. BHP’s contribution of $1.5 million to QAIHC is being distributed to its 26 member services (over 70 clinics) across the state to fund community-led responses to COVID-19. This funding could support these services to access isolation and quarantine facilities and much needed personal protective equipment (PPE) supplies.
“A lot of member services have provided extra community support, with some delivering food packages and electronics to school age children and paying for medications,” Angela said. “Also, extra blankets, tents and supplies dropped off to families – this level of support is certainly not the type of work they are normally funded for.”
In WA, Vicki, who is also CEO of member organisation Kimberly Aboriginal Medical Service, said BHP’s A$770,000 contribution would fill a shortfall in reusable PPE, fund food supplies for remote and very remote areas than have run short, and invest in video conferencing for telehealth services. The money also funded iPads for remote learning and also remote funerals for families who wanted to live stream proceedings.
“As Chair of AHCWA I am so proud our Aboriginal Medical Services in the state stepped up and have done things we would never do in our lifetime and provided services we’ve never had before,” Vicki said.
BHP Vital Resources Fund to keep telehealth in communities
And fifth, Vicki and Angela agree greater funding for telehealth has been a strong outcome.
“Telehealth is our biggest achievement,” Vicki said. “If you asked three months ago how telehealth going, I would have said limited. Our mob in the state here found a new way of providing specialist services to remote communities. Part of the BHP contribution will enable us to extend that further.”
BHP’s A$50 million Vital Resources Fund contributed more than A$3.3 million in funding to peak Aboriginal and Torres Strait Islander health councils and medical services across the country to support their communities as they transition from lockdown to recovery. Though we are yet to get a full picture of what life will be like in the pandemic’s shadow, the Aboriginal and Torres Strait Islander communities stand to benefit if the innovations introduced continue.