Healthcare Challenges for Aboriginal Communities

Discuss about the Miwatj Health Aboriginal Corporation.

The aboriginal communities have experienced the worst discrimination, especially when it comes to health care services  (Miwatj Health, 2017). As an indigenous population, their health profile was low before the Miwatj health corporation was initiated. In the entire Miwatj region, the aboriginal people had poor health status (MHAC, 2017). The low birthweight formed an identity of this group and their children were vulnerable to infectious disease, skin diseases, pneumonia, anemia, lack of dental care, and rheumatic heart disease  (Miwatj, 2016). With a population of about 2500 people, the Miwatj also suffered from the lifestyle disease yet the community worked hard to achieve better outcomes (Miwatj Health Aboriginal Corporation, 2013). The solution to this situation should focus on patient self-management and prevention. Miwatj Health has introduced various services that combine clinical services thus making it necessary to provide acute care services and long-term care planning. The organization also offers community-based programs to address the maternal and poor child health and chronic illness. Given the impact that Miwatj Health has created in the region, it becomes essential to form the basis of the study.

The representatives of the aboriginal started Miwatj Health in 1992 following their concerted efforts (Miwatj Health, 2015). It remains an independent community-controlled health service aimed at improving the well-being and health of the East Arnhem Land community  (Miwatj Health, 2017). The Regional Manager of ATSIC sent a memo to the representatives in the region on November 4, 1991 (Miwatj Health, 2015). This was a creation of the aboriginal people across the East Arnhem Land. The government offered the first fund to the corporation thus enabling it to acquire staff and equipment. The National Aboriginal Health Strategy was used by ATSIC to facilitate the funding. The Miwajt board members were privileged to join the ATSIC Board as elected board members  (Miwatj, 2016). This reflected the community-based origin thus offering a complete representation.

The motivation behind this formation was to fill the existing primary healthcare service gaps. The NT Government had abandoned the primary healthcare service programs thus making life intolerable  (Wiwatj, 2015). The Miwatj Health had established a constitution that aimed at assisting the aboriginal population to control their healthcare resources (Mulholland, 2008). In 1992, the corporation employed the first medical officer based on the audit of the health needs of the homeland residents  (Miwatj, 2016). By 1992, the health facility was operational, as it loaded patient data  (Miwatj Health, 2017). The organization also computerized the information of patients. Miwatj Health rarely operated clinics on its own but sourced doctors from Nhulunbuy offices to serve the communities based on the needs (Miwatj Health, 2015). By 1996, Miwatj Health established its first clinic in Gunyanara  (Miwatj, 2016).

The Establishment and Funding of Miwatj Health

Since in the remote communities, there were no houses, it became difficult to employ doctors  (MHAC, 2017) In the mid-1990s, the first doctors’ houses were constructed  (Miwatj Health, 2017). This followed the continued efforts and advocacy by Miwajt thus compelling the Commonwealth Government to support the initiative (Miwatj, 2016). By 1997, Miwatj built its Nhulunbuy clinic because the patients in the region experienced complex health problems that required quality-equipped facility (Miwatj Health, 2015). By 2000, it established a registered training organization where many aboriginal health workers received training services  (Miwatj Health, 2015). This is because; the local health officers were exposed to the community’s problems. Currently, the first graduates from the training facility continue to hold a critical position in different organizations across the East Arnhem Land  (Wiwatj, 2015).

The vision of the organization is to offer quality primary healthcare services for the aboriginal communities living in the region  (Miwatj, 2016). To this effect, the corporation coordinates the primary healthcare in the East Arnhem region (Miwatj Health Aboriginal Corporation, 2013). The organization will use the strategic objectives including demonstrating the culture of efficient and quality business performance  (Miwatj Health, 2017). Miwatj Health needs to consider expanding its service coverage across the aboriginal communities.

Miwatj Health is an Aboriginal-controlled service. The board of directors administers the services (Miwatj, 2016). With the members of the community running the facilities, it is possible to meet their needs and expectations. The aboriginal communities elect the board members.

The Corporationengaged in the provision of clinical services, business services, community-based public health programs, and policy, planning, and advocacy  (Miwatj Health, 2015). Miwatj Health is offering clinical services through the aboriginal health practitioners, nurses, and doctors  (Miwatj Health, 2017). Assisted health workers and the Community Workers support these physicians across the fixed clinics (MHAC, 2017). The professional services that the corporation provides also include treating acute trauma, diagnosis of illness, medications, post- and antenatal care, and child and full adult health checks  (Wiwatj, 2015). These facilities also offer mental health interventions, develop chronic disease care plan, drug and alcohol clinical assessments and radiological investigations  (Miwatj Health, 2017). Miwatj Health depends on the CARPA in offering clinical services (Miwatj Health Aboriginal Corporation, 2013). Given the limited resources provided to the organization, it has to balance the needs by offering acute care for patients in short-term, manage, and prevent long-term chronic illness. The maternal and child health problems also form part of the corporation’s clinical services  (MHAC, 2017). Currently, the organization receives funds to address maternal and child health issues and address chronic health diseases  (Miwatj Health, 2017).

Clinical Services Offered by Miwatj Health

The organization has also invested in providing community-based public health programs  (Miwatj Health, 2015). This involves offering the Raypirri Rom wellbeing programs to maintain families and children wellbeing and safety (Australian Indigenous Health Infonet, 2015). The wellbeing program ensures the families experiencing clan conflicts; drug misuse, alcohol abuse, and family violence get assistance through early intervention, crisis intervention, and prevention (Miwatj Health, 2017). In this wellbeing program, the organization has employed Yolngu workers informs the advisory committee of elders who authorizes the team and monitors them. The organization has also taken the frontline in handling healthy lifestyle and indigenous smoking  (Miwatj Health, 2017). It advocates for a healthy lifestyle among the aboriginal communities. According to the organization, physical exercise can prevent serious chronic illness not smoking (Miwatj Health, 2015). This is the only way the community can manage these illnesses. Previously, the traditional beliefs regarding the risk factors made it impossible for them to develop sporting infrastructure to help the community promote sporting activities  (Miwatj Health, 2015). The Miwatj’s Health Lifestyle program has helped the aboriginal to develop sustainable resources, activities, and knowledge thus addressing the barriers  (Miwatj Health Aboriginal Corporation, 2013).

Miwatj Health has established an administrative base in Nhulunbuy that is located in the Northern Territory of Australia (Miwatj Health Aboriginal Corporation, 2013). Nonetheless, the organization has established different clinics, which are located in Gunyangara, Nhulunbuy, Yirrkala, and Galiwin’ku  (Miwatj Health Aboriginal Corporation, 2013). In these clinics, patients can access a walk-in service for the preventive and acute care needs (Miwatj Health Aboriginal Corporation, 2013). Apart from the fixed clinics, the corporation has also established outreach teams that make regular visits to the nearby communities including Garrathiya Plains, Gunyanara, Birritjimi, Yirrkala, Galupa, and Galiwin’ku  (Miwatj Health Aboriginal Corporation, 2013).  

The contact details for these fixed clinics are shown below.

Nhulunbuy Clinic Ph. (08) 8939 1999 Fax. (08) 8987 3355 Opening hours: Mon: 08:30-16:00 Tue: 08:30-16:00 Wed: 08:30-16:00 Thurs: 08:30-16:00 Fri: 08:30-12:00	Gunyangara Clinic Elcho Island Ph. (08) 8987 3800 Fax. (08) 8987 3271 Opening hours Mon: 08:30-16:00 Tue: 08:30-16:00 Wed:  08:30-16:00 Thurs: 08:30-16:00 Fri: 08:30-12:00
Miwatj Health Aboriginal Corporation 1224 Arnhem Road P.O Box 519 Nhulunbuy NT 0881 Ph. (08) 8939 1900 Fax. (08) 8987 1670 Administration opening hours Mon-Fri 08:00-16:30	Yirrkala Clinic Ph. (08) 8987 2650 Fax. (08) 8987 3470 Opening hours: Mon: 08:30-16:00 Tue: 08:30-16:00 Wed: 08:30-16:00 Thurs: 08:30-16:00 Fri: 08:30-12:00
Nyalkanbuy Clinic (Galiwin’ku) PMB 230 Galiwin’ku via Winnellie NT 0822 Ph. (08) 8970 5700 Fax. (08) 8987 9061 Opening hours (24/7 on-call): Mon: 09:00-12:00& 13:00-16:30 Tue: 09:00-16:00& 13:00-16:30 Wed: 09:00-12:00 Thurs: 09:00-12:00& 13:00-1630 Fri: 09:00-12:00& 13:00-16:30	Ngalkanbuy Wellbeing Centre Elcho Island Ph. (08) 8970 5700 Fax. (08) 8987 9061
Malmaldharra Clinic Yurrwi Ph. (08) 8987 9903 Fax. (08) 8987 9940

The organization faces numerous challenges and issues that affect the delivery of quality health services to these targeted communities. The worst challenge is the limited funding that has compelled the clinics to balance short-term acute treatment and prevention with long-term chronic illness (Wiwatj, 2015). Since this is an indigenous health facility, the local communities should take over the funding initiatives to improve care delivery. The aboriginal population suffers greatly from diabetes, heart disease, obesity, and hypertension thus making it critical to intensify screening for these diseases (Gibson, 2017). Machado Joseph disease and kidney disease also present challenges to the organization (Miwatj Health Aboriginal Corporation, 2013). This is because the facilities do not have the capacity to care for such patients.

Community-Based Programs Addressing Indigenous Health

Similarly, the changing medicine and the care delivery approach are significant concerns. For instance, the aged care services offered to this population are no longer considered due to the short life expectancy (Gibson, 2017). These indigenous communities are facing the worst problem due to the high aging population (AMSAT, 2015). In the entire East Arnhem Land, there is no home built for the elderly  (Miwatj Health Aboriginal Corporation, 2013). The NT Government abolished the local community council thus affecting the management of the health services  (Miwatj Health Aboriginal Corporation, 2013). It has become critical for the Miwatj to overtake the running and management of clinics (Miwatj Health Aboriginal Corporation, 2013). Based on the high demand for health services, the facilities have experienced strained (AMSAT, 2015).

Based on my experience interacting with aboriginal patients visiting the clinics, I got an impression that the community is in dire need of quality health care programs. Indeed, the short-term management of acute syndromes is draining the society thus compromising the objective and vision of the organization (Wiwatj, 2015). Organising the referrals for patients with acute illness, especially the respiratory and lung diseases expose them to serious medical problems. It is, therefore, important for the NT Government to consider funding these programs to expand the infrastructure to accommodate the growing demands. The facilities must be equipped and expanded to help the needy patients in the community.

Conclusion

The report has exposed the challenges the aboriginal communities experience regarding healthcare services. Miwatj Health has a mission to improve the health services and delivery in this community. Despite its mission, Miwatj Health experiences various challenges and issues. It has identified the loopholes that require redress to improve the health care services. The history of the organization defines its mission of restoring thehope of the abandoned aboriginal communities who could not access quality healthcare services. The reflection has highlighted the worst challenge that community and stakeholders must undertake to improve the situation.

References

AMSAT. (2015). AMSAT Annual Report 2014-2015. Retrieved October 3, 2017, from https://www.amsant.org.au/wp-content/uploads/2015/11/webAmsant-annual-report-2015.pdf

Australian Indigenous Health Infonet. (2015). Description. Retrieved October 2, 2017, from https://www.healthinfonet.ecu.edu.au/key-resources/organisations?oid=1027

Gibson, J. (2017). Aviation Fuel Sniffing in Arnhem Land Sparks Health Emergency Warning. ABC News. Retrieved October 3, 2017, from https://www.abc.net.au/news/2017-05-15/aviation-fuel-sniffing-on-elcho-island-a-public-emergency/8521020

MHAC. (2017). Introduction to Miwajt Health. Retrieved October 2, 2017, from https://miwatj.com.au/introduction/

Miwatj. (2016). Annual Report 2015-2016. Retrieved October 2, 2017, from https://miwatj.com.au/dev/wp-content/uploads/2017/03/Miwatj-Health-Annual-Report-2015-2016-reduced.pdf

Miwatj Health. (2015). Miwatj Health Annual Report 2013-2014. Retrieved October 2, 2017, from https://miwatj.com.au/dev/wp-content/uploads/2015/09/Miwatj-Health-Annual-Report-13-14.pdf

Miwatj Health. (2017). Our Story. Retrieved October 2, 2017, from https://miwatj.com.au/introduction/our-story/

Miwatj Health Aboriginal Corporation. (2013). Strategic Plan 2013-2017. Retrieved October 2, 2017, from https://miwatj.com.au/dev/wp-content/uploads/2013/09/Miwatj-Health-Strategic-Plan-2013-2017.pdf

Mulholland, E. (2008, June). Improving Health in East Arnhem Land. Retrieved October 2, 2017, from Issue Magazine: https://www.issuesmagazine.com.au/article/issue-june-2008/improving-health-east-arnhem-land.html

Wiwatj. (2015). Annual Report 2013-2014. Retrieved October 2, 2017, from https://miwatj.com.au/dev/wp-content/uploads/2015/09/Miwatj-Health-Annual-Report-13-14.pdf