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See the chapters 'Education for Health', 'Sharing Health Information' and 'Strategies for Health Promotion' in Volume 1 for ideas on the process of conducting community education programs |
The following section suggests ways that you may be able to work with the community to improve things for the whole community. A really useful book is The Grog Book: Strengthening Indigenous Community Action On Alcohol by Maggie Brady (1998).
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See the chapters 'Education for Health', 'Sharing Health Information' and 'Strategies for Health Promotion' in Volume 1 for ideas on the process of conducting community education programs |
Share health centre statistics regularly with council, women's centre or health boards or committees. The process can raise awareness and stimulate action for change. Some statistics that can be shared include:
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Also see the section on 'Using Screening' in the chapter 'Strategies for Health Promotion' in Volume 1 |
Sharing financial statistics can also raise awareness and increase motivation to act on the issue.
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Help people calculate how much money they are personally spending on alcohol and other drugs per week, month and year | |
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Show people what else they can buy with this amount of money. For example: |
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Calculate together (using store turnover or other figures), how much the whole community is spending on alcohol and tobacco each month and year. This figure will be more accurate if the store is the primary source of supply |
| An alcohol example... One community in the East Arnhem District was planning to bring in some alcohol restrictions. People talked about how much money was being spent on alcohol. They found that a lot of money was going out of the community - $450.00 every day, $3 150 each week, or up to $157 000 each year leaving the community on grog. Example provided by Living With Alcohol Program |
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You can also start to think about and discuss the social cost to the community, for example, unfed children, fights and arguments, neglect of ceremonies. This area can be sensitive, especially when talking about senior people dying from alcohol or tobacco related illnesses |
| Talking with families about Sorry Business When talking about people with a long history of alcohol-related problems, most family members focused on other issues, such as the exact circumstances surrounding the last event. This may be in part because families do not want to speak badly about the dead, or because there is such a high background of alcohol-related problems, that its significance tends to get lost ... deaths are primarily spiritual and social events for Aboriginal people, but we also need to think of them as health events and share different types of knowledge so people can see both sides. Rosas and Weeramanthri 1993:7 |
| Advice from a remote area worker... Obviously a lot of the assaults and traumas and so on, associated with fighting, or family violence associated with alcohol are going to come to the health centre. It is really important to identify them. If a person is affected by alcohol or by petrol sniffing, it is important to identify that on the person's card or the incident sheet. Often people are aware that drug related problems happen, but they don't know how big the problem is. Once they do realise how big it is, they get quite a shock, and may be prepared to act on it if it's bought to their notice in a meeting. So my feeling would be for health staff to tell the council. Go to a council meeting, a formal council meeting, put it on the agenda, say that there are these numbers of kids being treated or alcohol related problems being treated, and you feel it's of serious concern, and that it's important for the community to discuss the issues. Anne Mosey, Facilitator, Remote Area Night Patrols, Central Australia |
Supporting health weeks is one health promotion activity that many health staff like to participate in. Like any health promotion project, the most effective health weeks are ones that involve interested community residents in planning and doing the activity.
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Advocate for or help organise a health week in the community. The community health week could tie into a National Health Week. For example, the health centre could focus on alcohol and its effects on the heart during National Heart Week |
Every year around the end of May or June there is a 'Quit Week' in the Northern Territory. The general aim of the week is to raise awareness about tobacco related issues. The week has a theme which focuses on a particular issue around tobacco, for example, smoke free policies. 'World No Tobacco Day' is the day in 'Quit Week' where people are encouraged to quit smoking for at least that day.
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Get ideas and support (possibly some financial support) for 'Quit Week' from the Alcohol and Other Drugs Program. See the contact list at the end of this chapter |
Possible activities include:
| By Eagle class - sung in rap style Don't you smoke HEY! You won't go far It's time to Quit From 'Be Smoke Free 1996: A Report' by Pozy Dalgleish, |
Like other health weeks, 'Quit Week' and 'World No Tobacco Day' do not usually cause big changes in most people's lives. They are good for raising awareness, giving information and getting people to think about the issue.
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Make the most of such health weeks by following up with brief interventions, linking them to other projects or providing the community with on-going health information |
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Sharing stories about how other communities have approached alcohol and other drug issues can get people thinking. Visiting other communities or having people come from other places can also help. Talk the matter through as a team before making decisions on visits or visitors | |
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Discussing other communities can be sensitive and make people uncomfortable. Privacy needs to be respected. We advise not to use names of particular communities unless a report has been published with communities' consent. Discuss the subject first with other members of the Health Team |
Here is a positive story to be shared about how people in Santa Teresa are dealing with their alcohol issues:
| Spiritual Healing Centre in Santa Teresa The Spiritual Healing Centre was opened at Santa Teresa in March 1996. Two years ago I had a strong vision for a healing centre. This vision talked strongly of Health, Wealth, and Spirit of our People. Health, in the sense that our people have strong ties with their land, spirit and people. The belief that all our people were healthy and free in spirit, was to be healthy and care-free. Wealth, in the sense that all that is of the spirit spoke clearly of a person's connectedness with everything around them. All knowledge and understanding of life and all living things was naturally borne in them. Spirit, in the sense that we are not one with one-self, but we are connected altogether with the Ways of the Elders, the Mother Earth, the Spirits of the Land and everything to do with Creation. Since the Centre opened, changes have started to happen slowly. Before the Centre, not many children were going to school but with the awareness and education about the effects of alcohol and how it is affecting them, the attendance has improved. There is a positive energy around the community and the people are picking up on it. The Alcohol Awareness Program for the children range from pre-school to Transition, primary to post primary and for those doing correspondence and gives the children and young people the awareness about themselves. They are special and they need not be tied down with the problems of adults. Hopefully, in the year we will be looking to setting up programs for the youth of this Community. The Centre and all who work in it are people who have journeyed long and hard trying to struggle with repairing those damages that alcoholism has done. We are trying to build people's life energy force, to pick up their self-esteem and make them part of the Community. When people feel trapped and can't do things, they get stuck in shame and stop learning. This Centre is about awareness of self, caring and sharing. It is all about airing their thoughts to free their minds and spirit. Agnes Palmer, Santa Teresa |
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Support schools to run health education sessions about alcohol and other drugs by: |
- providing or organising for appropriate resources
- providing factual information on alcohol and other drugs
- providing your expertise as a health care professional, particularly to support the teachers
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Offer information and respond to requests from other groups in the community such as the women's centre, night patrol, community council, health boards or committees, sporting groups, youth groups |
| The Australian Health Promoting Schools Association states that ...
"strategic partnerships ... make the most effective use of the available expertise
and resources." Vision Statement for Health Promoting Schools in Australia |
The following story is an example of what can happen when the Education Department and Territory Health Services work together with the community.
| The Maningrida 'Be Smoke Free' Project Aboriginal people in the Top End of the Northern Territory (NT) have among the highest rates of smoking in Australia and as a consequence suffer an enormous burden of ill-health. In spite of this, there is very little information about how many Aboriginal school children smoke, when and why they start and what interventions help to reduce the uptake of smoking. This project aimed to describe the current knowledge, attitudes and practices regarding tobacco use in school-aged children, and to develop and evaluate a culturally sensitive intervention that is readily adaptable to other remote Aboriginal communities of the Top End. A two-week educational intervention was conducted in one of three participating remote communities in the Top End. Pre- and post-intervention questionnaires about current practices, knowledge and attitudes to smoking were administered by local staff in all three communities. The intervention encompassed both community and school-based events over a two-week period and included:
The intervention met with considerable enthusiasm and community-wide support.... The children enjoyed participating in the project. Using the CD-ROM was the most popular activity and has been subsequently well received in smoking education projects in the two non-intervention communities. In spite of reasonable knowledge of adverse health effects, smoking cigarettes appeared to be perceived as an acceptable and expected part of being an adult.... In spite of the high prevalence of smoking in indigenous communities of the Top End there is interest, enthusiasm and potential for successful smoking prevention programs. This is important because smoking is a major but preventable cause of illness and death. Extracts from an article by Johnston F, Beecham R, Dalgleish P, |
An important prevention strategy to address alcohol and other drug issues is to have a range of recreational and sporting activities available for all community residents. Activities should not be targeted only at those with alcohol and other drug problems. If only 'users' have access to the prevention programs, it increases attention on them and can appear to be rewarding them.
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Support recreational activities by encouraging discussion and sharing ideas on activities such as: organising sporting events and regular hunting trips; purchasing music equipment; buying a pool table or table tennis equipment; setting up a gym; having blue-light discos; getting art and craft activities happening; building community recreational areas |
People may have ideas about what they can do in their own community with the resources that are available.
One strategy used in the past to address petrol sniffing has been to take those sniffing petrol to outstations (see Shaw et al 1995:14-16). Activities may include cattle or camel work, fencing, schooling, hunting.
Benefits include:
This method requires maximum community involvement if it is to work. There are also some limitations of this strategy if it is the only one being implemented. Problems include:
The Aboriginal Living with Alcohol team responds to requests from communities that have identified alcohol as a local issue in need of attention and action.
The team will visit the community for up to two weeks at a time to assist local community members in deciding what needs to be done and how to implement action. During their visits the team can:
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See the contact list at the end of this chapter |
Alcohol has been named as a major contributing factor to family violence in Aboriginal communities. If family violence is an issue in the community, talk with interested community residents about having an AFVS Project Officer visit. See the contact list at the end of this chapter.
How AFVS Project Officers work with communities in a four stage
approach...
From Aboriginal Family Violence Strategy: |
Night Patrols consist of concerned and respected community residents who intervene in and prevent alcohol and other problems in their community. Some are made up of men only and others primarily of women. The community determines what the Night Patrol will do. In some places they patrol at regular times each week and in other places they will respond to problems as they arise. They have no power to arrest or detain. They alert the police if there is alcohol being brought into a community. They talk to drunk people, ask them to leave the community or quiet them down.
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Meet with the Night Patrol to find out how they work in the community. Discuss how you can work together, for example, what sort of resources the health centre might be able to make available to help the Night Patrol members do their work | |
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Share information. Night Patrol members and health staff might be interested in sharing health information about alcohol and other drug use and statistics, sharing tips about how to deal with intoxicated people, or working on prevention projects together | |
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For more information about night patrols see Central Australian Remote Area Aboriginal Night Patrols : A Review by Anne Mosey (1994) |
Sobering up shelters provide a safe place for people who are drunk to sleep off the acute effects of alcohol. People may get a bed for the night and sometimes a good meal the next morning. Taking drunk people to a shelter is a way to stop them hurting themselves or other people. It is a harm reduction strategy.
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For more information about sobering up shelters, see the Intervention section in The Grog Book: Strengthening Indigenous Community Action On Alcohol by Maggie Brady (1998) | |
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If there is a sobering up shelter in the community, meet with the staff to see how health staff can support their work. Shelters can also provide an opportunity to share some information with people about alcohol | |