Strategies for promoting healthy living practices

The Environmental Health Officers within THS have adapted the UPK Report nine healthy living practices to meet the priorities of the Environmental Health Program and Departmental priorities, and have added a tenth practice.

The healthy living practices can be used to plan and prioritise environmental health projects. In the following section the 10 healthy living practices provide a framework for action.

1. Washing people - especially children under 5
2. Washing clothes and bedding
3. Removing wastewater, sewage and rubbish
4. Maintaining food hygiene and water quality
5. Reducing crowding
6. Improving dog health
7. Controlling dust
8. Controlling temperature in living areas
9. Reducing risk situations (trauma)
10. Controlling insects and pests

1. Washing people - especially children under 5

		Find out about the community’s water supply. Is there enough water to meet the needs of the community (quantity)?
		Work with the community store to ensure that basic health hardware maintenance products are available. This includes such things as: septic-safe cleaning products, tap washers, plugs, lime, buckets, brooms, mops, buckets, rubber gloves etc.
		Encourage stores to stock and subsidise items needed for personal hygiene, such as: toilet paper, soap and shampoo (regular and anti-lice), face washers, towels etc.
		Talk with the Aboriginal Health Workers about the best way to give messages about washing to people (children, carers, men and women)
		Make use of any opportunity to raise awareness of the importance of washing children’s bodies, faces and hands often. Opportunities may be found during antenatal classes, at the Women’s Centre, etc.
		Carry out one to one hygiene and correct water-use education with carers of children and school children
		Make sure that local Aboriginal Health Worker training emphasises the importance of washing children’s faces and hands
		Support the community to set up a system for monitoring the condition of health hardware in houses

2. Washing clothes and bedding

If the community does not employ ‘home-maker carers’, explore the possibility.

		Inquire whether there are people in the community who are qualified to provide hands on training in homes, for example, on how to use equipment such as washing machines. If not, talk about the possibility of applying for funding to train some local people.
		Offer advice to people on washing machine purchase, installation and maintenance. For example machines:

• must have low water use
• should be able to work on a cold cycle only
• should not empty into a bath that is used to wash children
• should be resistant to rust and to high salt content water if that is an issue in the area
• should be simple to operate

Research done on which washing machines are the best for Aboriginal communities found that heavy duty commercial machines were the best.

		Contact the Centre for Appropriate Technology (CAT), Alice Springs, for more advice
		Find out who can maintain machines once they are installed
		Help to organise skills development at the Women’s Centre to cover correct use of washing machines, use of the right amount of soap, proper disposal of soap packets. See ‘Hands On’.

3. Removing wastewater, sewage and rubbish

Septic systems and waste water

		Speak with your local council, EHW and EHO if rubbish, water or sewage are collecting on the ground in the community and causing a health risk. Explain how the situation can affect health (see the section on an environmental health hazard)
		If the community has a waste disposal problem contact your EHW and EHO, assist the Council to write a submission, and supply local health statistics to support council submission to remedy the problem
		Encourage people to use protective gloves, boots and clothing when maintaining septic tanks. Septic tanks contain liquids and sludge that can cause infections
		Obtain a copy and read the Code of Practice for Small On-Site Sewage and Sullage Treatment Systems and the disposal or Reuse of Sewage Effluent, Territory Health Services (1996). Copies can be purchased from the Territory Construction Association in Darwin and Alice Springs (phone: 8981 9666)

Removing rubbish and solid waste, "sharps" etc

		Set a good example. Find ways to ensure that the Health Centre building and yard is always clean and welcoming
		Put lidded rubbish bins outside the Health Centre and arrange a system for rubbish removal. Remember that any changes you make have to continue when you’re no longer there
		Speak with the EHW/EHO. Find out what the issues are and what improvements can be made to the rubbish collection and disposal systems and find out how you can help
		Encourage recycling of waste whenever possible
		Support a campaign to reduce the use of disposable nappies. Explore ways to ensure that they are disposed of properly
		Encourage screening and fencing the tip site so that dumped rubbish, especially plastic bags, do not scatter in the wind
		Help to arrange for the collection of abandoned car bodies and other hard rubbish
		Contact ‘Keep Australia Beautiful’ about Territory Tidy Town and other Awards. If the community is not already involved then talk about what KAB has to offer
		Suggest a litter-a-thon to raise funds for local clubs. Local sponsors could contribute according to the volume of litter collected
		Obtain a copy and read Infection control in the health care setting : Guidelines for the Prevention of Transmission of Infectious Diseases, NHMRC (1996). This has to do with the disposal of ‘sharps’ etc.
		Obtain a copy and read the Guidelines for the Siting, Design and Management of Solid Waste Disposal Sites in the Northern Territory, Department of Lands, Planning and Environment, and Territory Health Services (1995)

4. Maintaining food hygiene and water quality

Contact your local EHO for information on food hygiene or if you suspect that there is a problem with food hygiene in the stores or takeaway in your area

Maintaining food hygiene

Share the following important information about safe food preparation with the community:

• keep outside and inside cooking areas clean; keep down the dust by sweeping and mopping inside; dispose of rubbish regularly, compost food scraps or give them to dogs
• refrigerate all foods that are likely to go off
• clean food preparation surfaces before you start preparing food. After finishing one task clean the bench or preparation surface before starting the next task.
  Note: if food is prepared outside the house or away from the kitchen, the inside of a box from the store can be used to provide a clean, disposable cutting surface for foods such as meat
• ensure cooking and eating equipment is cleaned after use and safely stored; for example, store cups and pans upside down and out of reach of dogs
• control pests and rodents (contact the Environmental Health Program for advice)
• wash hands with soap and dry them, before preparing food and after going to the toilet
• cook meat within half a day of killing the animal and make sure that the meat is properly cooked
• prepare food for one meal at a time
• keep flies out of the kitchen and keep food covered
• use hot water where possible and detergent for washing dishes
• do not cough or sneeze over food
• do not smoke while preparing or cooking food
• keep children away from the food preparation area

Prevent cross-contamination by:

• keeping raw food separate from cooked food
• keeping raw vegetables separate from meat
• using separate cutting boards, knives etc. for each type of food e.g. meat, fish, vegetables, cooked and uncooked foods

Maintaining water quality

		Check with your local EHW/EHO about whether monthly water testing for health risk assessment is taking place. The Essential Services Officer does this in major communities
		If you think that there are problems with the water quality in the community, contact the Community Council, the Essential Service Officer and the Environmental Health Officer. EHOs can arrange for additional or special samples. EHOs can also contact the Aboriginal Essential Services Branch of PAWA about any particular works that may be required
		Assist local people if they need support to approach the Essential Service Officer with problems (remember do things with people, do not do things for people)
		Find out from the water testing laboratory and the Community Council whether a comprehensive water analysis has ever been done for your community

5. Reducing crowding

Collect statistics on diseases that are related to crowding. For example:

• respiratory diseases (by droplet infection) such as influenza, pneumococcal disease and TB
• skin infections
• other diseases such as hepatitis A and a range of diarrhoeal diseases

It is possible to use this information to:

• inform the community about the size of a problem
• feed into data for the housing survey
• inform the Environmental Health Program, CDC and others
• support the community to advocate for improved access to appropriate, new housing
• apply for funding for house maintenance
• upgrade health infrastructure

		Encourage well designed outside living areas around houses in order to reduce the problem of overcrowding
		Talk to people about how overcrowding is linked to their health

6. Improving dog health

		Ask people about their dogs and observe the situation when you are out and about in the community - notice dog health, where and what they eat, where they sleep, defecate, etc.
		Talk about dog issues with others in the health team to identify whether there is a problem, and if so, to determine the extent of the dog health problem in the community
		If members of the community have expressed interest and are motivated to organise a program then you can help to prepare a submission to get funding, and you can help to organise things, for example, by helping to clarify roles and responsibilities Note: experience has shown that total community support is essential for a dog program to be successful
		Contact the Environmental Health Program for more information and assistance
		Keep relevant health statistics and information and present it to the Community Council in order to support moves to do a dog program
		If you have a dog, keep it as healthy and clean as possible
		Raise community awareness of the connection between sores on dogs and skin infections and diarrhoea in humans. This can be done, for example, through a school health education program
		Visit the houses of sick children to discuss the possible connection between the number of sick dogs, dog faeces, and the health of the child. This can strengthen the health education message

7. Controlling dust

		Support the development of a Community Environment Strategy (or Community Environmental Health Plan) that includes activities to reduce levels of dust in the community
		Maintain dust free outdoor areas around the Health Centre
		Demonstrate the link between growing plants, the reduction of dust and improved environmental health
		Educate about the health problems associated with dust
		Support and encourage projects that protect plants from children, livestock, dogs, motor vehicles and heavy equipment
		Support the development of community reserves and parks
		Contact Greening Australia, Tangentyere Council, or Julalikari Council for assistance and advice

8. Controlling temperature in living areas

		Encourage the Community Council and others to choose housing that is appropriate to their climatic and cultural needs
		Talk to people about ways to make their houses more comfortable to live in
		Encourage planting of shrubs, trees etc to serve as windbreaks and shaded areas

9. Reducing risk situations (trauma)

		Promote, organise or conduct safety education in the school, the Women’s Centre and at other sites
		Encourage and/or organise First Aid Training courses
		Help to organise fire safety drills
		Give accident awareness talks to women’s groups and work groups
		Suggest to the Council that trainers in safe-driving visit the community to conduct lessons for adults and youths
		Help to organise voluntary groups to report on and fix minor household problems that put people at risk
		Encourage residents to fence their yards in order to keep out wandering dogs
		Make sure that everybody knows that broken electrical fittings and exposed wiring must be reported to the housing mob straight away

10. Controlling insects and pests

In any community or household it is essential to cut down on the number of places where insects may breed. This is the safest and most important approach to controlling insects and is always preferable to the use of insecticides.

Flies, cockroaches and mosquitoes

Reducing the numbers of flies and cockroaches in the community or outstation will impact on a wide range of community health and hygiene issues.

Talk with people about the diseases carried by flies and cockroaches and how they can be prevented. Key information to share includes advice about:

• the importance of wiping children’s noses and keeping their faces clean
• brushing flies away from the mouth, eyes and ears
• washing every day and wearing clean clothes. This makes people less attractive to flies
• stopping flies feeding on cuts and sores. Either use dressings from the store or visit your Health Centre
• collecting and disposing of rubbish regularly. Rubbish should be buried if possible
• covering raw and cooked food to prevent flies or cockroaches walking on it to feed
• keeping food preparation surfaces clean

Mosquito breeding sites will continue to produce hundreds of mosquitoes until the sites are removed. Where water accumulates or stands in a container for more than ten days, thousands of mosquitoes will breed.

Contact EHOs and THS’ Entomology Branch (phone 8922 8502) for information regarding insects and pests

Insecticides

Share this important health and safety information about insecticides:

• insecticides are poisonous to humans as well as to insects. If they are used to kill insects always tell everyone in the house that insecticide is being used and advise on relevant precautions to take
• insecticides should not be used on people, directly on food, on benches where food is prepared or on food preparation utensils
• people need to understand the directions on the labels of insecticides
• containers of insecticide should be stored out of the reach of young children