 |
Look for other examples of 'Primary Health Care in action' throughout this resource |
The following examples show how community health teams, working within a community health centre setting, facilitated community participation and enabled community members to increase control over their lives.
|
Look for other examples of 'Primary Health Care in action' throughout this resource |
There are regular health checks and minor treatments which some health centres encourage people to do for themselves. These include cleaning and dressing cuts and sores; blood sugar level monitoring; and blood pressure monitoring. The following example from the Ti Tree Health Centre shows how this approach can work.
| A Self Help Health Care Trolley: The Ti Tree Experience In September 1996 Ti Tree Health Centre established a self help trolley for people to check their blood sugar levels on a regular basis. The concept behind the self help trolley is one based on the principles of Primary Health Care. The primary goal of the self help trolley is to enable people to be more in control of their health, through participation and education. Another main reason for starting the trolley was that people who did not have any chronic conditions were coming in on a weekly basis requesting blood pressure and sugar checkups. It required a lot of time from the nursing staff. It was simple to set up and organise the trolley. We put a steel dressing trolley in the main waiting area of the health centre. On the trolley we put: an Advantage glucometer; a box of tissues; a sharps container; a record of acceptable ranges, and a note pad. After people have done the test, they write the results on the note pad and hand it to a staff member. At this point we have a bit of a chat about their result and what they've may been doing that may have affected their reading. We talk about diet and exercise, how they've been since the last checkup, and so on. This is particularly important if the results are too high or too low. Nursing staff then transfer the results into the person's file. In the initial stages of self testing there was slight confusion over why people were being taught to use the sugar machine. After all, this was the "job of the Sister". The challenge was to educate people to participate more in sharing some responsibility for monitoring their own health indicators. We asked for help from two women in the community. They both have diabetes and require regular blood sugar level (BSL) checkups. These women were taught how to use the glucometer and record the results. As word started to get around on the 'bush telegraph' that these women were using that 'sugar machine' themselves, we found people coming to the health centre just to look. We offered to teach them how to use the equipment and interpret the results. This process took about two months. The benefits of the exercise are now very evident. People are more aware of the normal ranges of BSL. More importantly they are now more familiar with changes in their own blood sugar levels. People with diabetes now talk more freely and openly about their condition. The health centre is now expanding on this concept of self help health care. We are now providing a bowl of castor oil and cotton buds to be wiped around the children's eyes to prevent fly bites. The health centre has also purchased an automatic blood pressure monitor so that people can check their own blood pressure. Information provided by Gayle Blennerhassett, |
| Using Bauhinia root in Elliott Health Centre Six years ago an Aboriginal woman brought her son to the health centre with a grossly swollen and infected thumb. He was febrile (had a fever), had a lump in the axilla and was lethargic (had no energy). He required evacuation to Tennant Creek Hospital for lancing of the thumb and intravenous antibiotic therapy. The child's mother, however, refused to give consent for the evacuation. On the following Monday the mother returned to the health centre to inform us that the child was at school and his thumb was almost healed. So what had happened? The mother had used a particular bush medicine called bauhinia root. Over the next 18 months we experimented with preparing and using a variety of bush medicines for skin sores that community women were pleased to bring us. We tried lemon grass and hakia bark, orange tree, and ti tree. Finally the bauhinia root was the only medicine that would last in glass storage for up to 6-8 weeks. Despite the anecdotal information we were getting from the results, Territory Health Services was not happy that we were using bush medicine as their usefulness and safety had not been scientifically proven. A review of the Elliott monthly statistics showed that sores, boils and scabies were the most common problems seen and treated in the health centre. We decided to do a scientific study comparing bauhinia root with three other commonly used western preparations. After extensive community consultation we obtained consent from 360 Aboriginal and non-Aboriginal people to participate in the study. We designed a research project which met accepted research standards. Results of the study showed that : Overall the bush medicine was considered better than the western preparations because it is used traditionally. There were other benefits of the research project: School children (both Aboriginal and other) participated in groups with the women who collected the roots and prepared them. Using bush medicine in the health centre legitimised the use of traditional remedies. By collecting and preparing the ingredients themselves, people have more control over their lives. They have become more involved in their treatment and dependence on western style treatment was reduced. Health staff took the opportunity to talk to children about the need for daily showers, washing and airing bed clothes, not having sick dogs sitting on beds and clothes, kidney disease, and how it can occur, if sores are not treated. An ongoing practice of education of families regarding hygiene and the use of bush medicine was established. A number of mothers who understood the scabies and sores problem now help other mothers with their children's hygiene - so a treatment oriented strategy became a preventive strategy. Elliott Health Centre still uses bauhinia root for the treatment of skin sores today. Information provided by Elliott Health Centre Staff |
To achieve the aims of the Ntaria Women's Cancer Prevention Project, health staff worked closely with the grandmothers in the community and a number of other individuals, programs and organisations. The project aimed to increase knowledge and understanding of issues and increase numbers of women having pap smears and doing breast self-examination. Another aim of the project was to demonstrate to the community a commitment to providing health services in a way that was appropriate for the community.
| The Women's Health Project In the remote Aboriginal community of Ntaria (Hermannsberg), the staff of the health centre started a project to change the attitude of local women towards prevention strategies for cervical and breast cancers, because they were worried that not enough women were involved in regular 'pap' screening and breast self examination. In 1998, Glenda Lucas (RAN), who played a key role in the project, approached other team members about their views on women's health issues. She expressed concern that, as non-Aboriginal health professionals, nursing and medical staff may not be delivering services which are culturally accessible and acceptable to community women or AHWs. She asked, "How can we find out the views of community members? Who are the key people who need to be involved?" Personal letters were sent to the senior community members. She explained her concerns about women's health in Ntaria (and surrounding communities). The letters gained a very favourable response - particularly from the women who had recently attended a cultural law meeting attended by women from throughout the Territory. These women believe that the health of Aboriginal women and breakdown of cultural law are very much interrelated. September was Ntaria's Women's Cancer Prevention Month. Ntaria community health centre received funding for women's health resources.The aims of the project were decided through a series of health team meetings with women in the community. One senior woman suggested that before non Aboriginal health staff could raise their issues with Arrernte women, they would have to be made aware of some important cultural knowledge (Women's Business). The project therefore began with a Women's Cultural Health Workshop, a camp held over two days on the traditional lands (belonging to Mavis Malbunka). The camp brought together as many women as possible to talk about women's health from a cultural perspective as well as from the non-Aboriginal health perspective. This camp decided on activities for the rest of September. It also informed the women of activities they could participate in during that month, which included visits from town based health staff and other organisations. The visitors provided information on services and general health education on STDs, Well Women's Checks and Cancer prevention. The continence nurse adviser visited as well. After the camp, the THS Communicable Disease team came and did well women's checks and screening at the health centre during a week following the women's camp. A range of educational videos, printed material and CD-Rom resources on various women's heath issues were made available at the health centre and could be accessed at any time. Tea and light snacks were provided during times when large numbers of women were expected in the health centre. This type of women's camp has been held over the last four years as a strategy to involve women in health education activities. The impetus came from the senior AHW Violet Long who encouraged Glenda to organise the camps; "this is your job, you have to do this". Information provided by Kerry Taylor, |